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Young Leader's Reunion Consent Form

Young Person's Name

Surname

Young Person's DOB

Emergency Contact Name

Emergency Contact Number

Any medical details, dietary requirements or SEND that we need to be aware of?

Consent: I give permission for my child to... *

attend the Young Leaders & Young Adults Reunion

have his/her photo taken. (These may be used by any church connected to Kidz Klub.)

Your name

Relationship to Young Person

Your Email

by Kidz Klub Harlow

Kidz Klub is run by churches in Harlow: Harlow Baptist Church is responsible for Kidz Klub but runs events in full partnership with St Mary's, Churchgate Street & Harefield Church.

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