Application for a place at Holiday Club

Book now for Songs - Games - Bible Stories - Craft - Quizzes - Prizes - Refreshments
and lots of fun!!

Cost: £1.00 per child per day

Reserve a place at the Monsters Stink Holiday Club by completing this form:


No thanks - return to the main MMBC web site


Details of the children wanting to come to Holiday Club
Full name of child 1     Male   Female     Date of Birth
School   School Year
Full name of child 2     Male   Female     Date of Birth
School   School Year
Full name of child 3     Male   Female     Date of Birth
School   School Year

To add more children, please complete and submit this form again with the additional information.

What days would you like to attend?
Monday     Tuesday     Wednesday     Thursday    

Details of the parent/guardian
Full name of parent/guardian Address
Phone Number
Email Address

Emergency and Other Information
Emergency Contact Name Emergency
Contact Phone Number
GP Name GP Phone Number
Any known allergies or conditions (include name of child if more than one is registered on this form) Any Other Information

I give permission for my child/children to be photographed for
inclusion onto the Melton Mowbray Baptist Church website:
    Yes   No
I give permission for my child/children to be photographed
for publication in the Melton Times Newspaper and Website:
    Yes   No
I am happy for these details to be retained securely for one year so that I can be contacted about other children's activities at Melton Mowbray Baptist Church:     Yes   No


I confirm that the above details are complete and correct to the best of my knowledge.

In the unlikely event of accident or illness, I give permission for any appropriate first aid to be given by the nominated first-aider.
In an emergency, and if I cannot be contacted, I am willing for my child to be given hospital treatment, including anaesthetic if necessary.
I understand that every effort will be made to contact me as soon as possible.

Yes    (by checking this box, you agree to the above)


Thank you - You'll hear from us soon.


Back to the main MMBC web site