Creche Registration Form Use this form if you are leaving your child in creche during an English Class or the Sunday Morning service. Full name of child Date of Birth Address PARENT / CARER DETAILS Name Relationship to child Telephone MEDICAL INFORMATION Details of any medication, medical problems, or disabilities Is your child allergic to anything? Does your child have any special dietary requirements? Does your child have any behavioural issues we should be aware of? Is your child up to date with vaccinations? Select... Yes No Unsure EMERGENCY CONTACT Name and phone number of an additional contact PERMISSIONS 1. I give permission for my child to take part in the normal activities of this group. Yes No 2. I am willing for this information to be stored in keeping with the church’s Data Protection Policy. Yes No Date of Registration I confirm that the information provided is accurate to the best of my knowledge. Submit Registration
