1st St. Ives Boys' Brigade and Girls' Association Joining Form

 

1. First name and surname of child *

 

2. Address of child *

 

3. Child's date of birth *

   DD/MM/YYYY 
 
 

4. Sex

 

5. Doctor/Surgery address and phone number *

 

6. Please provide details of any medical conditions, allergies, dietary requirements or additional needs.

 

7. Primary contact's name, address, phone, email and relationship to child. *

 

8. Secondary contact's name, address, phone, email and relationship to child. *

 

9. Additional emergency contact's name, phone and relationship to child *

 

10. Photo Consent *

 

11. Permission *

 

12. Name of person completing form and relationship to child. *

 

13. Date form was completed *

   DD/MM/YYYY 
 
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