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Name of first child:

Date of birth:

Name of second child:

Date of birth:

Name of third child:

Date of birth:

Name of carer:

Carers contact number:

Relationship to child(ren):

Email address:

Parent/Guardian:

Phone number:

Home Address:

Name and telephone number of additional contact:

Do any of your children in attendance suffer from any allergies?

Yes

If yes please give details:

Confirm1

I would like to register the above child(ren) with Trinity Tots and accept that I am fully responsible for them whilst they are in attendance.

Confirm2

I agree to the church collecting and storing my personal information for communication purposes.

Raster

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