Summer Club 2019 Registration Form

Child's name:

Home Address:


Contact Person:                                               Contact Phone Number:


Alternative Contact:                                        Alternative Contact Phone Number:


E-mail address:

Class (August 2019):

p5   p6   p7   S1   

 Any additional needs, allergies or medical issues we should be aware of?


On Wednesday 14th, there is a trip to Rollerbowl. Please indicate which option you would like:
I will take my child directly to Rollerbowl (6.15pm) and pick them up at the end (8pm).

My child requires a lift to Rollerbowl (meet at the church at 6pm and return at 8.15pm) and I give permission for them to travel in a leader’s car.

My child will not be attended on the Wednesday night.

Data protection: For your child to attend the club, we need to store your contact details at the church in case of emergency, and to give you information about the club. Data will be stored securely and not passed on to any third parties. Click here to view our full data protection policy.

I give permission for Kinmylies Church to contact me with information about other relevant events and activities 

I give permission for photos of my child to be taken for display within the church 

I give permission for photos of my child to be taken and displayed on the church website or Facebook page

I give permission for my child to take part in activities at the Summer Club