All Saints Hove Hut Youth Group

Registration Form September 2012

For those in primary school, Hove Hut meets between 1800 and 1920 on Wednesday evenings during term time. For those in secondary school, Hove Hut meets between 1900 and 2030 on Wednesday evenings during term time.

Start and end dates will be advised in advance, by email where possible and on the Hove Hut page on the church website. Special activities will be notified by email and consent forms will be available in the previous weeks.

PLEASE COMPLETE THIS FORM IN BLOCK CAPITALS

CHILD’S DETAILS

Full name………………………………………………………………………………..

Address……………………………………………………………………………… …

…………………………………………………………………………………………..

HomeTelephone……………………………………………………………………… ...

Date of birth…………………………………………………………………………….

School…………………………………………………………………………………. ..

School year group………………………………………………………………………

ALLERGY DETAILS Whilst your child is in our care, it would be helpful for us to know whether he/she suffers from any allergies or phobias or is on any medication. Is there anything else you would like us to know so that we can care for your child as well as possible? Any special needs?

…………………………………………………………………………………………. ………………………………………………………………………………………….

Family doctor's name…………………………………………………………………...

Address……………………………………………………………………………… …

………………………………………………………………………………………….

PARENT/GUARDIAN CONTACT DETAILS

Parent Name: …………………………………………………………………………...

Notification of start and end dates and any other necessary information is sent out by email where possible to save paper and postage. If you have an email, please do give it to us so we can spend the youth club money on fun stuff, and not on postage!

Parent Email……………………………………………………………………………..

Emergency Contact Name and Number ………………………………………………

…………………………………………………………..………………………………

Second Emergency Contact Name and Number ……………………………………...

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PICKUP DETAILS (SENIORS ONLY)

All children at the junior group should be brought and collected by their parents, unless specific arrangements have been agreed with the Hove Hut leaders.

My child will be brought and collected from the group.

YES  NO 

My child has my permission to travel to and from the group without me. YES  NO 

PARENTAL CONSENT

I agree to my child attending the Hove Hut Youth Group and taking part in the activities each week.

Signed………………………………………………………………………………….

Date……………………………………………………………………………………

Please print name……………………………………………………………………..