Jesse Tree Registration Form

Please complete this form to register your child for the Jesse Tree Stay & Play.. This information will be kept in agreement with GDPR and will be destroyed at the end of each academic year. For more information like us on Facebook (St John’s Church, Perry Barr) and follow us on Twitter (@StJohnPerryBarr).

Adult's full name including surname (your name) *

Your relationship to the registered child/ren *

Child (1) name: *

Child (1) date of birth: *

Child (2) name:

Child (2) date of birth:

Child (3) name:

Child (3) date of birth:

Your home address *

Home and/or mobile telephone number *

Your email address *

Are you first-aid trained (in case of accident/emergency)? *

Yes

Emergency contact details: name, relationship, number and address of someone who is able to come and collect you and/or any of the children within your care: *

I agree that i am responsible for the behaviour and safety of the child(ren) who I bring to the Jesse Tree Stay and Play. I have read the rules of safety and enjoyment. *

Yes

Our contact number is 07907 779814. Please indicate how you would prefer to be contacted with news, updates and events throughout the year. Would you also like to join our Jesse Tree WhatsApp group? *

Text Message

Post

Yes - put me in the WhatsApp group

Have you read the Jesse Tree Stay and Play's Rules of Engagement? *

Yes

* Required Fields