Shere, Albury and Chilworth Holiday Club 2018

Registration and consent form for Holiday Club
Please fill in a separate registration form for each child.

All fields must be filled in.
For more information on registering your child, please click here.

Child's details

Date of birth:
tooltip Children from age 5 to 11 can be registered. Children who have just completed year 6 can choose to be part of a group at Holiday Club or be a young leader.

Parent/Guardian's details

Your Address

Select which days you would like your child to attend
Tuesday              Wednesday              Thursday              Friday
How many are coming to Family Night? tooltip August 30th, family night is open to all families with children at Holiday Club and will be held in the early evening. It is a simple hot dog and salad supper plus delicious puds while having the opportunity to see what has been going on at Holiday Club. We do need accurate numbers so we can cater for everyone.

Emergency Contact Details

Doctor's Details:

Medical conditions:

Allergies, strong likes and dislikes or special needs which your child may have


Details of any medication required and/or dietary requirements

By giving us this information, we are best placed to meet your child's needs and ensure appropriate levels of adult supervision and/or staffing. This information is vital to ensure that the child you are registering has a happy and fulfilling experience at holiday club. If you have any questions, please contact Sheena Pearson


I give permission for my child's and my details to be kept in the church records. Yes  

I give permission for images of my child to be taken, stored and used in holiday club information and publicity. (We use group shots only.) Yes   

In the unlikely event of illness or accident, I give permission for any appropriate first aid to be given to my child by a nominated first aider.
I agree to emergency medical treatment being given as considered necessary by the medical authorities if I cannot be contacted. I understand that every effort will be made to contact me as soon as possible.

All the information I have provided is accurate to the best of my knowledge. I have read this form. Yes

We take the protection of your personal information seriously and want to comply with our obligations under the General Data Protection Regulation. Further information can be found here.

How can we contact you?

Phone              Email              Post             

Click CANCEL if you do not wish to continue

When you have filled in the form click on the SEND button

If you have any queries about registering your child, please email Registration enquiries.