The local churches
pray that you find
peace and joy
Holiday club Monday 8th August — Friday 12th
(for Reception — Year 6 children) will take place at Berkswich Methodist Church on Monday 8 August — Friday 12 August 2022 from 9.45 am until 12.30 pm. The cost is £3 per day. Fill in this form to book a place for your child (please use a separate form for each child). You can deliver forms (with payment please) to 38 Mendip Avenue for the attention of Hilary Reynolds. We will register your child and will confirm with you that your child has a place. Alternatively, you can email the form to firstname.lastname@example.org but we will need payment before the event. (Cheques should be made payable to children@Berkswich.)
There will also be a BBQ on Friday 12 August at 5 pm — no charge!
Child's Full Name
Date of Birth
Parent's/Guardian's Full Name
Emergency Contact Name
Emergency Contact Number
GP's Phone Number
Any known allergies, medical conditions, dietary needs or special needs
PARENTAL CONSENT HOLIDAY CLUB 2022
I give permission for my details & my child's details to be entered on an email contact list. I understand that this information will not be shared with anyone else and will only be used to contact me about future events. This is in accordance with the General Data Protection Regulation Act 2018. Y/N
I acknowledge the need for obedience and responsible behaviour on his/her part. Y/N
I give permission for first aid to be given by the nominated first aider. Y/N
I agree to emergency treatment including anaesthetic being given to the child named above if this is deemed necessary and I/we cannot be contacted. (We would make every effort to contact you). Y/N
I will not allow my child my child to attend if he/she is displaying any Covid symptoms or has had a positive Covid test. Y/N
Photographs of the children may be taken at the event but will not be uploaded onto any social media sites.
Please inform us separately in writing if you would prefer your child not to be included in photographs.
WE ARE NOT ABLE TO REGISTER CHILDREN ON THE DAY
PLEASE REGISTER MY CHILD FOR BERKSWICH METHODIST CHURCH HOLIDAY CLUB 2022.
I CONFIRM THAT THE ABOVE DETAILS ARE COMPLETE AND CORRECT TO THE BEST OF MY KNOWLEDGE.
PLEASE CIRCLE THE DAYS YOUR CHILD WILL BE ATTENDING.
Mon Tues Wed Thurs Fri
Signature of parent/guardian Date
TOTAL NUMBER OF ADULTS FOR BBQ TOTAL NUMBER OF CHILDREN FOR BBQ