2022 Holiday Club

NCC Holiday Club is 4th-8th July and is for children P1-P6. This includes those going into P1 or those who just finished P6

Name of Child/Participant*
First Last
Date of Birth*
DD slash MM slash YYYY
What school year will child be entering in August?*
Address*
Street Address City ZIP / Postal Code
Name of Parent/Guardian*
First Last
Home Phone*
Email (Parent/Guardian)*

Your email will be used to communicate further details regarding holiday club
Does the child have any allergies?*
- Yes
- No
(PLEASE INCLUDE FOOD ALLERGIES)
If Yes, please list any allergies & medications you may be taking:
Are there any medical or other issues that may prevent your child from participating in the activities?*
- Yes
- No
If Yes, please give us any details that will be helpful
Emergency Contact #1*
First Last
Emergency Contact #1 Phone*
Emergency Contact #2
First Last
Emergency Contact #2 Phone
Medical Treatment*
In the event of an emergency, and emergency contacts cannot be reached, do you give consent to seek medical treatment if it is necessary?
- Yes
- No
Photographs/Video*
Occasionally, leaders will take photos or videos to be used for promotional material in upcoming events for Niddrie Community church. Do you give permission for photos or videos to be used should your child appear in any?
- Yes
- No
Consent*
I agree that the above information is accurate and give NCC consent for my child to participate
Name of Parent/Guardian giving consent*
First Last
Date*
MM slash DD slash YYYY