Welcome to the form for adult helpers!  Filled this out before?  Go here!

Didn't want this one?  The form for children is here, and the form for young helpers is here.

Want any of the details of holiday club again?  Head back here!

Name *
Days Attending *
Medical Details
Are you taking any medicine or undergoing any treatment that needs to be continued during the event? *
Are you known to be allergic or sensitive to anything (e.g. medicines, food, etc.)? *
Do you have any specific dietary requirements? *
Is there any other important medical information you feel you should disclose? *
Emergency Contacts
Name *
Name *
I would be willing to help in the following areas:
Additional Permissions
Do you give permission for the above details to be held after the event? *
[This means you don't have to fill this form out again!]
May we use these details to contact you about other, similar events in future? *
[i.e. future holiday clubs]
Child Protection
Guidelines from the Home Office following the Children Act 1989 advise that all voluntary organisations, including churches, take steps to safeguard the children who are entrusted to their care. Please therefore answer the questions below (answering ‘yes’ will not necessarily bar you from working with children). We may also ask you to complete a criminal records check through the Disclosure and Barring Service.
Because of the nature of the work for which you are applying, this post is exempt from the provision of Sections 4(i) and 4(ii) of the Rehabilitation of Offenders Act 1974, by virtue of the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975, and you are therefore not entitled to withhold information about convictions which, for other purposes are ‘spent’ under the provisions of the Act. In the event of an appointment, and failure to disclose such convictions could result in the withdrawal of approval to work with children in the church. If you tick ‘yes’ to any of the following, please provide details below.
Do you have any current or spent criminal convictions, cautions, bindovers or cases pending? *
Have you ever been held liable by a court for a civil wrong, or had an order made against you by a matrimonial court? *
Has your conduct ever caused, or been likely to cause, harm to a child or put a child at risk or, to your knowledge, has it ever been alleged that your conduct has resulted in any of these things? *

If you have any questions, you can contact someone using the list of contacts available here.