Tewkesbury Baptist Church

to reach the World for Jesus, beginning with Tewkesbury

'Landlubbers' Registration

landlubbers

'Landlubbers' Holiday Club is open to children aged 5 - 11 and will take place at Tewkesbury baptist Church.

The club will run every morning from 09.30 - 11.45 am from Monday 23 to Friday 27 August 2010.

The cost (which includes all materials and refreshments) for the week is £10 for the first child and £5 for each additional child. Please bring payment on the first day of Landlubbers.

As places are limited, please complete the form below (separate form for each child) as soon as possible to register your children. If you have any questions please contact Rachel Westlake.

Child's full name: Sex: Male Female

Date of Birth: School:

Names of other children in the family attending 'Landlubbers':

Parent / Guardian's full name:

Address:

Phone number:

email address:

Emergency Contact name:

Address:

Emergency contact phone number:

Doctor's name:

Doctor's phone number:

Any known allergies, conditions or special requirements:

Please register my child for 'Landlubbers' Holiday Club 23rd - 27th August 2010.

I confirm that I am the parent/guardian of the child and that the above details are complete and to the best of my knowledge.

I give permission for my child's and my details to be entered on the church database. I give permission for group photographs to be taken including my child.

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 anesthetic if necessary. I understand that every effort will be made to contact me as soon as possible.

Office Address:

Station Road

Tewkesbury

Gloucestershire

GL20 5DR