This form is to be completed in full by a parent or carer only, and covers all regular attendance at St Mary's Junior Church from June 2021 - August 2022.

Joining or returning to Junior Church

We cannot wait to see your children but are aware that this has been an exceptionally challenging year and as restrictions lift some will be keen to re-join Junior Church straightaway whereas others may plan to join later. 

In order for us to plan effectively and have the right amount of volunteers each week, we would really appreciate it if you could give us an indication of when you would like to return to Junior Church. (You will not be held to your answer! We know that things change, it is just to give us an idea).

 From the 13th June
 Once restrictions have completely lifted - 21st June onwards
 Once schools go back in September
 I'm not sure yet

Details of child:

Child's first name:
Child know as (if different from first name):
Child's last name:
Gender: Male
Home telephone:
Child's date of birth:
School year academic year 2020/2021:
Medical conditions / Additional needs:
Include any allergies (details of medication) and any additional support your child may need

Parent / carer contact details:

First name:
Known as (if different from first name):
Last name:
Relationship to child:
Mobile number:
Email address:

Media and electronic communication:

The church may also take photographs / video at groups which could include your child. They may be used to publicise further events or in church publications.  Any pictures or video taken will be used sensitively and in compliance with our Safe From Harm Policy, which is available to read here.
Do you give permission for photographs / video of your child to be used in printed material or in church services?
Do you also give permission for photographs / videos to be used on the church website and through the churches social media channels?


I understand that while involved he / she will be under the control and care of the group leader, and / or other adults approved by the church leadership and that, while the staff in charge of the group will take all reasonable care of the children, they cannot necessarily be held responsible for any loss, damage or injury suffered by him / her during or as a result of the activity.

I agree to remain on the premises during the time my child is taking par in junior church activities.

I agree for the church to hold the information provided on the church office database in accordance with the General Data Protection Regulation.  Please click here for details of our privacy policy.

I confirm that by clicking 'Send' I am submitting full and accurate information, that I am the parent / carer of the child named, and that I give permission for the child named to take part in the normal activities of the junior church groups.