Family Life Church

We meet at: "The Old Library", Finkle Street, Thirsk, North Yorkshire, YO7 1DA

Backpackers

Holiday Club 2019

Booking Form

Monday 5^th - Friday 9^th August 2019

9:30 a.m. - 12:30 p.m

Please fill in the booking form in full or we cannot accept the booking.
All contact information must be given for child safety reasons.
Please call Lydia Stirling on 07837-715294 if you have any questions

Online booking closes on Monday 29th July

Parent/Guardian's Name:
Email Address:
Address:
Telephone Number:
Name of Child:
Gender:	Male Female
Age of Child:
Name of GP:
Any known allergies?
Do you have any Medical/Dietary requirements?
In the unlikely event of illness or accident, I give permission for any appropriate first aid to be given by the nominated first-aider. In an emergency, and if I cannot be contacted, I am willing for my child to be given hospital treatment, including anaesthetic if necessary. I understand that every effort will be made to contact me as soon as possible.	Yes No
Which School to you attend?	Thirsk Community Primary School Sowerby Primary School All Saints Primary School Knayton C Of E Primary School Topcliffe C of E Primary School South Kilvington Primary School Carlton Miniott Primary School Other
Do you consent to pictures or videos being taken of your child, for advertisements, marketing, leaflets, or any other use; such as for training, educational or publicity purposes?
Do you consent to your Data being held by Family Life Church?	Yes No, delete after Holiday Club is complete

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CONTACT US: Phone: 01845 868188 Mobile: 07837 715294, Email: admin@flcthirsk.co.uk | Charity Number: 1129813