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Diocese
of
Portsmouth
Registration form for children and young people
Childs details
Name ..
Address . .
Telephone number .
Date of birth ...
School
National Curriculum year group
Group the child is attending:
Camel Club at
Whilst your child is in our care it would be helpful for us to know whether he/she suffers from any allergies, is on any particular medication or whether there is anything else you would consider important for us to know, e.g. does your child have any special needs
NHS number . .
Family doctors name and address
Your details & consent
Telephone number in case of emergency . .
(The number of a close friend or relative in case you are not at home)
Signed (Parent/Guardian) Date .
26.11.06