In the unlikely event of illness or accident, I give permission for any necessary medical treatment to be administered by the nominated first aider, or by suitably qualified medical practitioners.
Should my child require emergency hospital treatment, I authorise an adult leader to sign on my behalf any written form of consent required by the hospital if I cannot be contacted. I understand that every effort will be made to contact me as soon as possible.
I confirm that the details on this form are correct to the best of my knowledge.
To be completed by a Parent or Guardian.
To provide for your child’s needs and to meet the requirements of the Local Authority we require the following information. It would be helpful if you complete this form online to reduce the time taken to register your child when you arrive at Holiday Club.
When you bring your child to Holiday Club you will be asked to sign a copy of this form and the declaration below. If there are any alterations you should let us know then. Please note the information will be transmitted by the web and email and will not be encrypted.
Alternatively forms will be available by request and at our morning services on July 9th and 16th.
Thank you for your co-operation.
Items in Purple are Essential
To enter more than one child please submit for the first child and then use your browsers back button twice to return to the form.
Then you can alter the appropriate details and press resubmit for the next child.
You should receive an Acknowledgement within two days
Child's First name and Surname
Date of Birth dd/mm/yyyy
First Line of Address
Alternative number during Holiday Club
School Attended Last year
Place of worship attended or None
Black / Black British
Asian / Asian British
Does your child need left handed scissors?
Do you give permission for your child to be included in photos and video by authorised persons for use as the note above?
Does your child use an inhaler?
If so, will they bring it with them?
Does your child have any Allergies? If so please detail below.
Is there anything else we should know?
Name of Parent or Guardian
Email Address for response
Confirm email address
In order to control the publication of images, Photos and Video will only be taken by people specifically authorised to take photographs or video by the Church’s Safe Guarding officer, these people will wear an authorised badge. Other Photography and video recording will be prohibited.
Authorised photographs and video may be displayed at events organised by Mossley Hill Parish Church in printed form or by media projection. They may be published on the Mossley Hill Church Website and official Facebook Page. The Church will remove any images on request from relevant people. Published photographs may also be used by Liverpool South Deanery and Liverpool Diocese for general publicity.
Guardians of Ancora is here this week
We are sorry but we are no longer able to Process Online Registrations.
You are welcome to come along to the church at 1.00pm.
You will need to complete a card with the information as the form below on your first day, but please be prepared to wait with your child while those who have already registered are admitted.