Builth Wells Explorer's Bible Club

Child's Name

Name

Parent's Name

Parent's Email

This address will receive a confirmation email

Parent's Phone (also emergency contact no.*)

I understand that I will receive occasional text messages and/or emails regarding the youth events (i.e. time changes, updates on lifts, etc).

Yes

Address of Child

Child's Birthday

Child's Age

Child's School

Transportation Consent

Workers of the Children's Bible Club at Builth Wells are able to provide transportation for the child listed to and from their home/provided address and to/from specific events. This transportation will be in a minibus and/or car and the following principles will be adhered to:
• All drivers are safely recruited and hold the proper qualifications following national government guidelines and our safeguarding policy.
• Transport will be provided in vehicles that are roadworthy (i.e., MOT and appropriate insurance).
• Seatbelts must be worn by all occupants of the vehicle.

Transportation Permission

Yes No

Photography Consent

I consent for my young person to have their photo taken during events held at the Children's Bible Club at Builth Wells and its affiliated ministries under the Crown Christian Heritage Trust.

I consent for the Children's Bible Club at Builth Wells and its affiliated ministries under the Crown Christian Heritage Trust to display photos of my child at their discretion on (but not limited to) the church website, social media accounts and printed materials.

Photography Permission

Yes No

Medical/Allergies

Please list any medical conditions or allergies. If none, please type 'NONE.'

In the case of emergency, if I cannot be contacted, I agree to my child receiving medication or treatment as instructed by a medical professional.

I understand that my child will be under the care of the approved workers of the Children's Bible Club at Builth Wells and that, whilst the workers in charge of the group will take all reasonable care of the children, they cannot necessarily be held responsible for any loss, damage or injury suffered by my child during or as a result of the activity.

Medical Permissions

Yes No

Parental Digital Signature

Please type your full name to provide a digital signature for the above form.

Description

Please register for the Builth Explorer's Bible Club here

When? Tuesdays at 5pm
Where? Horeb Chapel, Church Street | Builth Wells LD2 3BA

Contact Number: 01982 559175

Builth Wells Explorer's Bible Club

Description

Please Fix the Following