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Holiday Club Registration Form

To reserve your place for this years Holiday Club please fill in the form below, alternatively you can pick up a form from the welcome desk on Sunday.

We cannot allow you’re child to attend Holiday Club unless we have a completed form, as it will give us valuable information regarding them should we need it.

  1. FAMILY CONTACT DETAILS
  2. Child's Name(*)
    Please let us know your name.
  3. Date of birth(*)
    / / Invalid Input
  4. Name of Parent or Carer(*)
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  5. Address
    Please let us know your message.
  6. Contact Tel Number(*)
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  7. Your Email
    Please let us know your email address.
  8. SCHOOL DETAILS
  9. School Name
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  10. School Year
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  11. EMERGENCY CONTACT DETAILS FOR PARENTS OR CARERS
  12. Contact name for an alternative adult in case of emergencies(*)
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  13. Contact Tel Number(*)
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  14. Relationship to child
    Invalid Input
  15. DROP OFF AND COLLECTION
  16. My child will be dropped off and collected by
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  17. Relationship to child
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  18. MEDICAL INFORMATION ABOUT YOUR CHILD
  19. Family Doctor Name/Surgery(*)
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  20. In the event of illness or accident, please indicate if medical treatment can be given by a nominated first-aider.
  21. (*)
    Invalid Input
  22. Does your child have any food allergies?(*)
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  23. Does your child have any medical conditions?(*)
    Invalid Input
  24. Is s/he on any medication?(*)
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  25. Does s/he have any special needs? (*)
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  26. If the answer is Yes to any of the above, please can you provide further information in the box below:
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  28. PHOTOTGRAPHY
    From time to time St Nicholas Church uses photo/video images for display on the St Nicholas Church website and internal noticeboards and/or film/photo images in video or printed materials developed and distributed by St Nicholas Church. Please select below if you give your consent for St Nicholas Church to use any film/photo images taken of your child for the purposes set above.
  29. Photo Permission(*)
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Address

icon towerSt Nicholas Church
Church Lane
Tooting
London
SW17 9PP

icon telemail0208 767 8033
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Location

i Location BigWe are located on the corner of Mitcham Road and Church Lane, a short walk from Tooting Broadway tube station view map

Sunday Services

icon clockMorning: 10:30am
Evening: 6:00pm
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FAQs

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