{"id":915,"date":"2018-05-10T08:00:35","date_gmt":"2018-05-10T08:00:35","guid":{"rendered":"https:\/\/scsparishchurches.uk\/?page_id=915"},"modified":"2018-05-24T08:54:43","modified_gmt":"2018-05-24T08:54:43","slug":"summer-holiday-club-2018-registration-and-consent-form","status":"publish","type":"page","link":"https:\/\/scsparishchurches.uk\/index.php\/summer-holiday-club-2018-registration-and-consent-form\/","title":{"rendered":"Summer Holiday Club 2018 &#8211; Registration and Consent Form"},"content":{"rendered":"<p><!--vcv no format--><\/p>\n<div class=\"vce-row-container\">\n<div class=\"vce-row vce-row--col-gap-30 vce-row-columns--top vce-row-content--top\" id=\"el-db0f3457\" data-vce-do-apply=\"all el-db0f3457\">\n<div class=\"vce-row-content\" data-vce-element-content=\"true\">\n<div 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\" id=\"el-4d398870\" data-vce-do-apply=\"background el-4d398870\">\n<div class=\"vce-col-inner\" data-vce-element-content=\"true\" data-vce-do-apply=\"padding margin  border el-4d398870\"><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"vce-row-container\">\n<div class=\"vce-row vce-row--col-gap-30 vce-row-columns--top vce-row-content--top\" id=\"el-0592888e\" data-vce-do-apply=\"all el-0592888e\">\n<div class=\"vce-row-content\" data-vce-element-content=\"true\">\n<div 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\" id=\"el-a07685e7\" data-vce-do-apply=\"background el-a07685e7\">\n<div class=\"vce-col-inner\" data-vce-element-content=\"true\" data-vce-do-apply=\"padding margin  border el-a07685e7\">\n<div class=\"vce-text-block\">\n<div class=\"vce-text-block-wrapper vce\" id=\"el-b2a148c9\" data-vce-do-apply=\"all el-b2a148c9\">\n<h2 style=\"text-align: center;\">Registration and Consent Form<\/h2>\n<h3 style=\"text-align: center;\">Summer Holiday Club 2018<\/h3>\n<h3 style=\"text-align: center;\">Highgate School, Sileby<\/h3>\n<p style=\"text-align: center;\">10am to 12:30pm &#8211; July 30<sup>th<\/sup>&nbsp; 2018 to 1<sup>st<\/sup> August 2019<\/p>\n<p style=\"text-align: center;\"><a href=\"https:\/\/scsparishchurches.uk\/index.php\/events\/summer-holiday-club-2018\/\">Click here for full details of Summer Holiday Club<\/a><\/p>\n<p>Please complete the form below if you would like your child to attend Egyptian Adventure holiday club run by the United Benefice of Sileby, Cossington &amp; Seagrave.&nbsp; If you have more than on child who would like to attend you will need to complete one form for each child.<\/p>\n<\/div>\n<\/div>\n<div class=\"vce-raw-html\">\n<div class=\"vce-raw-html-wrapper\" id=\"el-848f1e03\" data-vce-do-apply=\"all el-848f1e03\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f912-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"912\">\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\/915#wpcf7-f912-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=\"912\" \/><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-f912-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> Current school year (required)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"school-year\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"school-year\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"R\">R<\/option><option value=\"1\">1<\/option><option value=\"2\">2<\/option><option value=\"3\">3<\/option><option value=\"4\">4<\/option><option value=\"5\">5<\/option><option value=\"6\">6<\/option><\/select><\/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> Name of school attended (required)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"name-school\"><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-school\" \/><\/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 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> 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> Parent\/Guardian phone number - where we can contact you in case of emergency during holiday club (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> GP\u2019s name, address and phone number (required)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"name-GP\"><textarea cols=\"60\" rows=\"6\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"name-GP\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><label> Any known allergies, medical conditions, current medication * (see note over the page) 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> If medication is required during this or future events, then please ensure it is brought to the event with written instructions for administration. <\/label>\n<\/p>\n<p><label> Please name adult(s) who will be collecting child from event (required)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"name-adults\"><textarea cols=\"60\" rows=\"2\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"name-adults\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><label>Name and contact number of another adult \u2013 will be used only if we cannot contact you in case of emergency (required)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"other-adult\"><textarea cols=\"60\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"other-adult\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><label> I give my permission for my child to participate in the Egyptian Adventure Holiday Club and any other church-related activities I apply for during 2018\/2019 (required)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"child-permission\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"child-permission\"><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> In the unlikely event of illness or accident I give permission for any necessary medical treatment to be given by the nominated first-aider. (required)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"child-firstaid\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"child-firstaid\"><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> In an emergency, I give permission for my child to receive hospital treatment, including anaesthetic, if necessary. I understand that every effort will be made to contact me as soon as possible. (required)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"child-hospital\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"child-hospital\"><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>\tI give permission for my child\u2019s photograph to be taken and used (without names), if appropriate. (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><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Send\" \/>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"vce vce-separator-container vce-separator--align-center vce-separator--style-solid\" id=\"el-13ae2e00\" data-vce-do-apply=\"margin el-13ae2e00\">\n<div class=\"vce-separator vce-separator--color-b-43-207-203 vce-separator--width-100 vce-separator--thickness-1\" data-vce-do-apply=\"border padding background  el-13ae2e00\"><\/div>\n<\/div>\n<div class=\"vce-text-block\">\n<div class=\"vce-text-block-wrapper vce\" id=\"el-c2d48aca\" data-vce-do-apply=\"all el-c2d48aca\">\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>Registration and Consent Form Summer Holiday Club 2018 Highgate School, Sileby 10am to 12:30pm &#8211; July 30th&nbsp; 2018 to 1st August 2019 Click here for full details of Summer Holiday Club Please complete the form below if you would like your child to attend Egyptian Adventure holiday club run by the United Benefice of Sileby, Cossington &amp; Seagrave.&nbsp; If you have more&hellip;<\/p>\n","protected":false},"author":2,"featured_media":302,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-915","page","type-page","status-publish","has-post-thumbnail","hentry","ctfw-has-image"],"_links":{"self":[{"href":"https:\/\/scsparishchurches.uk\/index.php\/wp-json\/wp\/v2\/pages\/915","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=915"}],"version-history":[{"count":9,"href":"https:\/\/scsparishchurches.uk\/index.php\/wp-json\/wp\/v2\/pages\/915\/revisions"}],"predecessor-version":[{"id":927,"href":"https:\/\/scsparishchurches.uk\/index.php\/wp-json\/wp\/v2\/pages\/915\/revisions\/927"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/scsparishchurches.uk\/index.php\/wp-json\/wp\/v2\/media\/302"}],"wp:attachment":[{"href":"https:\/\/scsparishchurches.uk\/index.php\/wp-json\/wp\/v2\/media?parent=915"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}