Monday 29th July to Friday 2nd August 2019

9.15 am to 1.00pm – Manor Court School - Chard

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a time to have fun and learn about God and Joseph

through stories, games and crafts
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lunch will be provided
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for children reception to year 6 children
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it costs nothing to attend
but if you would like to give a donation that would be great
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if you would like more information or to book places please contact:
01460 65904 (24 hour answerphone)
or
cctholidayclub2015@gmail.com
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Pyramid Rock Holiday Club is organised by Chard Churches Together
Monday 29th July to Friday 2nd August 2019, 9.15am-1pm @ Manor Court School, Chard

Days attending Monday Tuesday Wednesday Thursday Friday

29 July 30 July 31 July 1 August 2 August

Please tick

Child 1
full name
Sex male female Please tick
Date of Birth School year (as
July ‘19)
School
Doctor’s name Doctor’s
contact no.
Any allergies, medical conditions or
special needs we need to know about?

Child 2
full name
Sex male female Please tick
Date of Birth School year (as
July ‘19)
School
Doctor’s name Doctor’s
contact no.
Any allergies, medical conditions or
special needs we need to know about?

Child 3
full name
Sex male female Please tick
Date of Birth School year (as
July ‘19)
School
Doctor’s name Doctor’s
contact no.
Any allergies, medical conditions or
special needs we need to know about?
 In the unlikely event of illness or accident, I give permission for any appropriate Yes No Please
first aid to be given by the nominated first-aider. tick

In an emergency, and if I cannot be contacted, I am willing for my child to be

given hospital treatment, including anaesthetic if necessary.

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

I give my permission for my details to be kept so my children can be invited to Yes No Please
future holiday clubs tick

I give my permission for my child’s photograph to be taken during the club (the Yes No Please
photos will be used for church purposes only e.g. magazines & publicity) tick

Parent’s/guardian’s signature

Parent’s/guardian’s full name

Address including postcode

Telephone number (mobile & landline – in

case of emergency)
E-mail address (this will only be used to
advertise future holiday clubs & won’t be
passed on to a 3rd party)

The completed registration form will be kept in a locked filling cabinet and backed up on password protected computers for the
period specified by the Chard Baptist Church Data Protection Policy (copies available if requested). Under Data Protection
legislation, the church secretary of Chard Baptist Church acts as the Data Controller and can be contacted by ringing 01460 65904
or emailing admin@chardbaptist.org.uk. The completed consent forms will be taken to each session of the Holiday Club to make
sure the relevant information is always available.

We are collecting this information to ensure that the Holiday Club is organised in a responsible manner adhering all safeguarding
policies. Data Protection legislation allows us to process this information as we regard it as being in the group’s legitimate interest.

The information you have shared will NOT be disclosed to anyone else without your consent.

You have the right to ask to see any information we hold about you by submitting a ‘Subject Access Request’ to the Church
Secretary, who acts as the Data Controller. You also have the right to ask for information which you believe to be incorrect to be
rectified.

If you are concerned about the way your information is being handled, please speak to our Data Controller. If you are still unhappy
you have the right to complain to the Information Commissioners Office.

Please return this completed form to:

Chard Baptist Church, Holyrood Street, Chard, TA20
2AH
by Friday 19th July 2019 as spaces are limited