Parents’ / Guardians’ Name* First Last Which meeting time and site do (or would) you normally attend? (you can tick more than one!)* 9:30 @ Town Centre site 11:30 @ Town Centre site Mobile Phone Number*Please give the number we should use to contact you on a Sunday morning.Email* Address Street Address Address Line 2 City County / State / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country I consent to King’s Church High Wycombe holding and processing my personal data for the purpose of my involvement with King's Church High Wycombe. (NOTE: we will send you a separate email asking you to consent for us to hold your child's details and to identify how we may contact you about their involvement with the church)* Yes No We will hold your child's information for the duration of their involvement with King’s Church High Wycombe, and a record of attendance will be kept for 6 further years for the purpose of Safeguarding. At the age of 13, your child will be asked to give their own consent.I consent to being contacted by King's Church High Wycombe in regards to Kings' Kids.* Post Email Home Phone Mobile Phone You can view our Privacy Policy and change your contact preferences at any time by emailing office@kchw.co.uk or ringing 01494 459 901.YOUNG PERSON'S DETAILSYoung Person’s Name* First Last Date of birth* Age Group*Creche: Age 1 – 3 and a quarterSparklers: Age 3 and a quarter – School Year RShooting Stars: School Years 1 and 2Rockets: School Years 3 and 4Xplosion: School Years 5 and 6 Gender*BoyGirlDoes your child have any underlying medical conditions, such as asthma, epilepsy, diabetes etc? Please give details of any medication that they carry or any instructions that would be helpful to know.*Does your child have any allergies such as hay fever, nuts, medications etc? Please give details of any medicines they carry for these allergies and any instructions that would be helpful to know.*Does your child have any dietary requirements?*NoYesPlease give details belowIs there anything that we need to be aware of to help your child get the most out of King’s Kids? (thinking about things such as communication, receiving instructions, coping with change, making friends, etc)If drinks and biscuits, or sweets and icecream, are provided, are you happy for your child to receive these?*YesNoOn a Sunday morning, we may take school-aged children on a BLESS adventure or to an alternative venue. Are you happy with this?*YesNoWe have a King’s Kids rules poem, and if the children don’t keep to this then they will be given a warning. They will get 2 warnings and then will be brought back to you if needed. Indicate here that you agree with the policy.*YesNoLOVE RULES: To help us get along as we have FUN, make FRIENDS and MEET Jesus... Listen to the leaders, don’t interrupt; If you need the loo, tell that you do; Be polite, don’t fight; Join in the fun, include everyone. CONSENTI consent to my child's details being stored electronically and on paper for the purpose of looking after them on Sunday mornings.* Yes No You can request to be removed from our database at any time by emailing office@kchw.co.uk or ringing 01494 459 901.May we use your child’s image on our website or printed publications?* Yes No Please would you indicate if you're happy for your child to appear on King's Kids' social media channels and when live streaming King's Kids?* Yes No Please would you indicate if you're happy for your child to appear on the church's main social media channels and when live streaming the main meeting?* Yes No THANK YOU!Please click 'Submit' and then check that there are no additional fields to complete. If your form has been successfully received then you will see a confirmation message in the place of this form when the page has refreshed, and will also receive confirmation by email.
