GENERAL INFORMATION
PARTICIPANT DETAILS
PARENT/GUA DETAILS
EMERGENCY CONTACT
EMERGENCY CONTACT 1
EMERGENCY CONTACT 2
GP INFORMATION
PLEASE LET US KNOW OF ANY MEDICAL OR OTHER INFORMATION:
XPRESSION INFORMATION
T-SHIRT SIZE
KIDS CLUB
I have experience working with children
WEEKLY
i am willing to help with kids club
FRIENDS I WOULD LIKE TO SERVE WITH.
PARENTAL STUFF!
I CONFIRM THAT ALL DETAILS DECLARED ARE COMPLETE AND CORRECT TO THE BEST OF MY KNOWLEDGE.
in the unlikely event of an accident, I give permission for a trained first aider to treat my child. in an emergency were I or an emergency contact cannot be contacted: I give permission for my child/ward to be given hospital treatment including aesthetic if necessary. I understand that every effort will be made to contact me.
photographs will be taken for publicity purposes. should you wish your child's/ward's photo not be taken please tick here
I consent to the storage & use of my child/ward's email for the use of communication relating to events within xpression.
This email acts as a Digitial Signature, by entering it and submitting the form this will be taken in good faith as the required permission needed to partake in Xpression.