Junior Leader's Form

If you are under 18, we would love to have you join us as a junior leader. Please complete the application form below with a parent.
Personal Information:

Full Name:
Contact Number:
Email Address:
Date of Birth

Do you have any previous experience working with children?


Parent Information:
This section must be filled in by your parent.

Parent Name:
Parent Phone Number:
Parent Email Address:
Relationship to Child:

 I give permission for my child to volunteer at Holiday Club as a leader.

Medical Information:
GP Name:

GP Address:

GP Phone Number:

Details of any regular medication, medical condition (e.g. asthma, epilepsy, diabetes, allergies, dietary needs, etc.) special need or disability which may affect normal activity:


Holiday Club Details:
Would you be available to volunteer for every session of Holiday Club?
Holiday Club is on 17th, 18th and 19th February from 9.40am to 12pm, Sunday 22nd from 10.30am to 12pm
 Yes

Please select all of the age groups you would be willing to lead a group for:
 Years R to 2 (Ages: 4-7)
 Years 3 to 4 (Ages: 7-9)
 Years 5 to 6 (Ages: 9-11)

 At Holiday Club we may take photographs or video of leaders for display in the church or on our social media platforms only. 
Please untick if you DO NOT wish your child to be photographed or videoed.  No pictures or film will be published elsewhere on the internet.
 
Thank you for volunteering! Our leader's will be in contact soon. 

The information declared on this form is for use by the Holiday Club leaders only, for contact purposes and for our own records.  It will not be disclosed to any third party.