St. James Hope, 3 Vicarage Close, Salford, M6 8EJ
07771 558 058
info@salfordelimchurch.org

Kids Church – General Info and Consent Form

Dear Parent/Carer,

Please complete the following details to keep our records up to date. Thank you 🙂

    Child's Details

    Child’s Full Name

    Date of Birth

    School Year (if applicable)

    Home Address

    Contact Name, Numbers and Relationship to Child

    First Contact

    Name
    Relationship
    Mobile phone
    Home phone

    Second Contact

    Name
    Relationship
    Mobile phone
    Home phone

    Additional Information

    Details of any medical information including allergies.

    Details of any other important information.

    Unfortunately, we are unable to take children to the toilet or change nappies. Please indicate here if your child is able to take themselves to the toilet or you need us to come and get you/they are in nappies.

    Child can take themselvesChild in nappies/needs assistance

    Photograph and Image Consent

    From time to time, we like to take photos to be used on the website, or as part of a service (e.g. a photo on the screen). Please select Yes or No as to whether you consent to us using an identifiable image of your child/ren.

    Church Website
    YesNo

    Social Media (Facebook, Instagram, Twitter)

    The Sunday morning livestream to YouTube and our church website
    YesNo

    Your name
    Your email address
    Date completed