Leader's Form

Personal Information:

Full Name:
Contact Number:
Email Address:

Please provide the name of your Church:

Do you have any dietary requirements, allergies, additional needs or medical conditions the Holiday Club leaders will need to be aware of:

Please provide a name and phone number for an emergency contact:


Faith and Experience:
Please give a brief testimony of your Christian faith:

Do you have any previous experience working with children? Please provide any details of this.

Do you have a current DBS Certificate?
 Yes

Holiday Club Details:
Would you be available to volunteer for every session of Holiday Club?
Holiday Club is on 17th, 18th and 19th February from 9.40am to 12pm, Sunday 22nd from 10.30am to 12pm
 Yes

Please select all of the age groups you would be willing to lead a group for:
 Years R to 2 (Ages: 4-7)
 Years 3 to 4 (Ages: 7-9)
 Years 5 to 6 (Ages: 9-11)
If any of your children will be attending Holiday Club, please provide their name below:
(You will need to complete a children's form)


 At Holiday Club we may take photographs or video of leaders for display in the church or on our social media platforms only. 
Please untick if you DO NOT wish to be photographed or videoed.  No pictures or film will be published elsewhere on the internet.
 
Thank you for volunteering! Our leaders will be in contact soon. 

The information declared on this form is for use by the Holiday Club leaders only, for contact purposes and for our own records.  It will not be disclosed to any third party.