Booking Form

Zero
 

Please obtain Payment booking reference before filling in the Form

                              as places are  limited

 Step 1

Click here to pay     Tickets

 

 Step 2 fill in form and then press send at the end

Child's Name (One name per form)
Payment booking reference: (From Ticket Source)
Date of Birth
Age (Years/Months)
Present school year (must be currently in Reception to Yr 6)
Male/Female (M/F)
Name of Parent /Carer
Address:
Town:
County:
Postcode:
Telephone:
Mobile:
Email Address:
Emergency contact details (name & phone number)
In the Unlikely event of an accident I give permission for my child to be given any necessary medical treatment by the nominated First Aider   YES/NO
Does your child have SEN or EAL needs?  (This will help us to fully support your child and will NOT effect their booking):
Any food allergies:
Medical (and other allergies)
I consent to images of my child, named above, being used and stored for internal church purposes. I understand that the identity of my child will be protected at all times (YES/NO)
Any Comments?
I consent to Christ Church Purley processing my personal data for church use only. To withhold your consent, please contact the church office. 020-8763 8291: (YES/NO)
We will never disclose your information to anyone outside Christ Church Purley