{"id":1090,"date":"2018-07-17T10:53:23","date_gmt":"2018-07-17T10:53:23","guid":{"rendered":"https:\/\/scsparishchurches.uk\/?page_id=1090"},"modified":"2020-03-11T10:13:23","modified_gmt":"2020-03-11T10:13:23","slug":"squeals-on-wheels-application-request-form","status":"publish","type":"page","link":"https:\/\/scsparishchurches.uk\/index.php\/squeals-on-wheels-application-request-form\/","title":{"rendered":"Squeals on Wheels application request form"},"content":{"rendered":"<p><!--vcv no format--><\/p>\n<div class=\"vce-row-container\">\n<div id=\"el-0a53ccc2\" class=\"vce-row vce-row--col-gap-30 vce-row-columns--top vce-row-content--top\" data-vce-do-apply=\"all el-0a53ccc2\">\n<div class=\"vce-row-content\" data-vce-element-content=\"true\">\n<div id=\"el-43615f22\" class=\"vce-col vce-col--md-100p vce-col--xs-1 vce-col--xs-last vce-col--xs-first vce-col--sm-last vce-col--sm-first vce-col--md-last vce-col--lg-last vce-col--xl-last vce-col--md-first vce-col--lg-first vce-col--xl-first\" data-vce-do-apply=\"background el-43615f22\">\n<div class=\"vce-col-inner\" data-vce-element-content=\"true\" data-vce-do-apply=\"padding margin border el-43615f22\">\n<div class=\"vce-text-block\">\n<div id=\"el-9ae1dce0\" class=\"vce-text-block-wrapper vce\" data-vce-do-apply=\"all el-9ae1dce0\">\n<h2>Squeals on Wheels &#8211; St Mary&#8217;s Church baby &amp; toddler group<\/h2>\n<h3>Application form<\/h3>\n<\/div>\n<\/div>\n<div class=\"vce-raw-html\">\n<div id=\"el-11d3a4a8\" class=\"vce-raw-html-wrapper\" data-vce-do-apply=\"all el-11d3a4a8\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f1088-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"1088\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/index.php\/wp-json\/wp\/v2\/pages\/1090#wpcf7-f1088-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"1088\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.4\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f1088-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/fieldset>\n<p><label> Child's Full Name (required)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"child-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"child-name\" \/><\/span> <\/label>\n<\/p>\n<p><label> Postal Address (required)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-address\"><textarea cols=\"60\" rows=\"6\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"your-address\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><label> Date of Birth (required)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"date-ofbirth\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"date-ofbirth\" \/><\/span> <\/label>\n<\/p>\n<p><label> Any known allergies, medical conditions, current medication or special needs that we need to be aware of: (required)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"medical-conditions\"><textarea cols=\"60\" rows=\"6\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"medical-conditions\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><label> Parent\/Guardian name (required)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"name-parent\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"name-parent\" \/><\/span> <\/label>\n<\/p>\n<p><label> Relationship to Child (required)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"relationshipto-child\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"relationshipto-child\" \/><\/span> <\/label>\n<\/p>\n<p><label> Parent\/Guardian phone number (required)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"tel-parent\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"tel-parent\" \/><\/span> <\/label>\n<\/p>\n<p><label> Parent\/Guardian Email (required)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span> <\/label>\n<\/p>\n<p><label> Alternative contact name in case of emergency during Squeals (required)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"name-emergencycontact\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"name-emergencycontact\" \/><\/span> <\/label>\n<\/p>\n<p><label> Emergency contact phone number (required)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"tel-emergency\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"tel-emergency\" \/><\/span><br \/>\n<\/label><label> I understand that all data is managed in accordance with GDPR 2018 and all<br \/>\nSqueals helpers have undergone a DBS check. <\/label>\n<\/p>\n<p><label>\tI give my consent for my child to be photographed whilst taking part in activities at Squeals and for<br \/>\nthese photographs to be displayed within the Benefice and on the Benefice website. (required)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"child-photograph\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"child-photograph\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"Yes\">Yes<\/option><option value=\"No\">No<\/option><\/select><\/span> <\/label>\n<\/p>\n<p><label> I give permission for you to retain this data for the purpose of informing me about future events. (required)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"data-retention\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"data-retention\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"Yes\">Yes<\/option><option value=\"No\">No<\/option><\/select><\/span> <\/label>\n<\/p>\n<p><label> <strong>In submitting this form you are agreeing to the following:<\/strong> <\/label>\n<\/p>\n<p><label> I understand that whilst every care and attention will be given to my child, the United Benefice of Sileby, Cossington and Seagrave and the leaders and helpers of the event cannot accept any responsibility for personal accident or loss\/ damage to personal property. <\/label>\n<\/p>\n<p><label> HEALTH AND SAFETY<br \/>\nSqueals are committed to ensuring that we provide an opportunity and facility for you to spend quality time with your child\/ren.<br \/>\nAs part of this safeguarding I confirm that I am aware that my child\/ren are my responsibility whilst attending Squeals.<br \/>\n<input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Send\" \/><\/label>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"el-626bcdc9\" class=\"vce vce-separator-container vce-separator--align-center vce-separator--style-solid\" data-vce-do-apply=\"margin el-626bcdc9\">\n<div class=\"vce-separator vce-separator--color-b-43-207-203 vce-separator--width-60 vce-separator--thickness-1\" data-vce-do-apply=\"border padding background el-626bcdc9\"><\/div>\n<\/div>\n<div class=\"vce-text-block\">\n<div id=\"el-2397fd7a\" class=\"vce-text-block-wrapper vce\" data-vce-do-apply=\"all el-2397fd7a\">\n<p>The <span style=\"color: #000000;\"><strong>United Benefice of Sileby, Cossington &amp; Seagrave<\/strong><\/span> takes the security of your data very seriously. Please read our <strong><a href=\"https:\/\/scsparishchurches.uk\/index.php\/data-privacy-notice\/\">Data Privacy Policy Notice<\/a><\/strong> for further details.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<p><!--vcv no format--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Squeals on Wheels &#8211; St Mary&#8217;s Church baby &amp; toddler group Application form The United Benefice of Sileby, Cossington &amp; Seagrave takes the security of your data very seriously. Please read our Data Privacy Policy Notice for further details.<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1090","page","type-page","status-publish","hentry","ctfw-no-image"],"_links":{"self":[{"href":"https:\/\/scsparishchurches.uk\/index.php\/wp-json\/wp\/v2\/pages\/1090","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/scsparishchurches.uk\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/scsparishchurches.uk\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/scsparishchurches.uk\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/scsparishchurches.uk\/index.php\/wp-json\/wp\/v2\/comments?post=1090"}],"version-history":[{"count":12,"href":"https:\/\/scsparishchurches.uk\/index.php\/wp-json\/wp\/v2\/pages\/1090\/revisions"}],"predecessor-version":[{"id":2129,"href":"https:\/\/scsparishchurches.uk\/index.php\/wp-json\/wp\/v2\/pages\/1090\/revisions\/2129"}],"wp:attachment":[{"href":"https:\/\/scsparishchurches.uk\/index.php\/wp-json\/wp\/v2\/media?parent=1090"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}