2024 Activity Days Booking Form

One form per child please.

You will receive confirmation of your place by email.

I would like to book a place for my child on the activity days on…….

Tuesday 23rd to Thursday 25th July (3 days 10am – 3pm)

You will receive confirmation of your place by email after this time.

"*" indicates required fields

Child's Name*

First Last

Age*

(Min age - 4yrs and going into Reception)

Date of Birth*

School Year*

Gender*

Is their birthday during the week of the activity days?*

Yes

Your E-mail Addres*

(required as main form of contact regarding activity days)

Address*

Street Address City ZIP / Postal Code

Phone number*

Emergency contact*

(name, address if not home, phone no)

Are there any friends/relatives with whom your child would like to be placed in a group?*

(Please provide their names and we will do our best to put them together)

Please detail anything about your child which will help us*

(allergies, health problems, educational or special needs)

Have you attended previous activity days at St Johns Church?*

Yes

Permission*

I give permission for my child to be taken on supervised short walks around Muxton or to the park next door (click the box for Yes)

I give permission for my child to be given first aid if required

I give permission for photographs of the activity days which may include my child, to be used by the church, including on our website. Photos will be included in a thank you letter which goes out to the sponsors of the event. No faces will be shown. (click the box for Yes)

I will be able to accompany my child to a short service at the end of the day on Thursday 27th July to show you what we have been up to. (click the box for Yes)

Name of Parent/Guardian*

First Last