Beeches Road's Mums & Tots Consent Form

Child's Full Name

Child's Address

Child's Birthdate

Child's Age at Enrollment

Do you consent for photographs to be taken of your child whilst at our playgroup for use on social media platforms (FB, etc) or other promotional means for the church? Not to be sold in anyway. Simply for church/ministry use.

Yes

Do you consent for your child to participate in snack and/or craft time?

Yes

Do you consent for your young person to receive any required medical care should the need arise and agree to not hold the church responsible for any accidents or injuries that may occur whilst playing at the playgroup?

Yes I'd rather not.

Please let us know of any medical conditions or allergies that effect your child or that may effect the behaviour of your child when playing alongside other children:

Parent/Guardian Email

This address will receive a confirmation email

Parent/Guardian Mobile No.

Digital Signature (Please enter full name)

Description

Wednesdays at 9:15am to 11:15am

FREE Mums & Tots Registration Form
Held at: Beeches Road Baptist Chapel's Good Shepherd Hall
75 Beeches Rd
Rowley Regis, B65 0AS

• One form per child

Beeches Road's Mums & Tots Consent Form

Description

Please Fix the Following