Children and Young People: Annual Registration and Medical Information Form

We require the parents or legal guardians of all children who enrol for our activities to complete a Registration and Medical Information Form each year (academic) year.

For your convenience, you can now complete this online. If your children wish to take part in any of the activities at which parents are not present (Sunday Special, Explorers, Wednesday Club, or Holiday Club) during the academic year 2018-19, you need to complete this form - either on paper or online. It is important that this information is kept up to date: Please notify us of any changes.

Child's Details
The usual name by which they are known
Parent's Details
We need contact details for one parent or legal guardian.
Please give both your first name and your surname.
We will use this to send you a copy of the details you are giving us now, and we may use it to let you know of other updates or pieces of news. We never give information to any other organisation, except if required by a legal authority.
Medical Details
If your medical practice allows you to see any GP at the practice, you may give the name of the practice instead.
Medical History / Needs

If the answer to any of the following questions is YES, please give details in the box at the bottom of this section.

Has the child ever been actively sensitive to Penicillin
Does the child suffer from any allergies?
Does the child carry any medication that needs to be taken regularly
Does the child suffer from a condition or illness requiring regular treatment?
Is you answered "YES" to any of the questions above, please give details