Hero Factory Register • Influence Church

Child's Details

First Name *

Last Name *

Date of Birth *

School Grade

Special Needs Child

Do you consent to photos or videos taken of your child at Hero Factory to be used in publicity for Hero Factory or Influence Church? *

Yes

Parent / Guardian Contact Details

Mobile

Phone

If in an emergency I am not contactable, I give consent for my child to receive doctor / hospital treatment *

Yes

Address

Address Line 1

Address Line 2

Town / City

County

Post Code

Data Submitted

First Attendance *

Privacy

By completing this form, I consent to Influence Church using and storing my personal data digitally, for the purposes of general Church administration, pastoral care and communication as stated in our Privacy Policy located on our website.

Child's Details

Parent / Guardian Contact Details

Address

Data Submitted

Other Info

Privacy