Dynamites Music Rego Form

Dynamites Music is a music playgroup run by St Marks Anglican Church, Freshwater.
Please also forward this form to the parent if you are the nanny, grandparent or other carer.

By filling out this form you agree:

I hereby release and discharge all associated with Dynamites Music from all responsibility and liability for any accident or sickness which may befall the child/children specified below, or any damage to his or her property while attending Dynamites Music.

Your details

First Name *

Last Name *

Mobile Number *

Email Address *

Your relationship to the child *

Parent

Grandparent

Nanny

Other carer

If you are not the parent, please provide the parent's name

Child details

Child's first name

Child's last name

Allergies

Any special needs or other info which will help us give your child the best possible care?

I give consent for photos of us to be used for advertising purposes online *

Yes

I give consent for photos of us to be used for advertising purposes in print/email/whatsapp *

Yes

Data Privacy

The leadership team of St Marks Freshwater will treat this information confidentially. This information may be shared with a third party when it concerns medical health or care of the individuals listed. If you wish to access this information or have any queries in relation to the manner in which we handle your personal information, please do not hesitate to contact us.