Join Kids Club

KIDS CLUB REGISTRATION

Childs' Name(Required)
DD slash MM slash YYYY
Childs' Name
DD slash MM slash YYYY
Childs' Name
DD slash MM slash YYYY
Address(Required)
Parents or Caregivers(Required)
EMERGENCY CONTACT (if parents are not available)(Required)
People NOT authorised to collect your child.
Permission for your child/ren to walk home(Required)
Permission for photographs(Required)
To be used for display and promotional purposes

NB: Please notify us of any changes to the information provided on this form.

Payment
Payment for Kids Club is optional but appreciated as your donation allows us to provide afternoon tea and activities.
Payment Method

Bank Details for Kids Club koha/donations

After completing the form you will recieve an email to make an online payment or please find the details below for payment via internet banking. Account Name: The Village Presbyterian Church | Account Number- 02 0800 0849993 03 Please indicate which group you wish to contribute to in the reference (i.e. Kids Club)
Sign Here(Required)
DD slash MM slash YYYY