The Abingdon Society of Bellringers and the
Churches of St Helen & St Nicolas, Abingdon

CHILD REGISTRATION RECORD for Bell Ringers

NAME Please underline the first name the child is called by

Date of birth

National curriculum year group

School

ADDRESS

	
TELEPHONE CONTACT
Parent/Guardian’s home

Parent/Guardian’s work

Parent/Guardian’s mobile

Of another close relative/friend for use in an emergency. (Please give their name and relationship)

Whilst in our care it is important we know whether your child -
•	Suffers from any phobias, disability or known allergies?

•	Is on any medication?

•	Has been immunised against Tetanus within the last ten years?

•	Has any health condition we should know about?

•	Has any special dietary requirements?

Please also tell us of any particular likes, dislikes or fears your child has.

Registered GP (name, address and telephone number)

	

YOUR DETAILS 

Parent/Guardian name

Address

Signed…………………………………………………..Date………………………………	

I understand that to assist in the keeping of a register to comply with the Child Protection Policy it is necessary to keep details on the database belonging to St Helen’s Church.  I understand that the database is only used by the Church and authorised tutors of the Abingdon Society of Bellringers and that data will not be passed to a third party, except in the case of an emergency where my child may be at risk.

I understand that the original copy of this form will be retained by the Tower Captain and only passed to his/her deputy in the event of him/her being absent from a bellringing session.

I give my permission for the child named over this page to attend bellringing and to take part in any organised activity such as outings to other towers. (All ringing activities, including travelling to and from ringing, are covered by the insurance policy of the Oxford Diocesan Guild of Church Bell Ringers for members of the Guild, and learners are covered whilst they are ringing under the instruction of a Guild member.  All activities have been approved by the PCC, and all activities at St Helen’s & St Nicolas’ are covered by their own insurance.)

I accept that I am responsible for transporting my child to and from the church for bellringing, and that the group leaders are not responsible when my child leaves the church.

List any special instructions that we should be aware of:
............................................................................................................................. .............................................................................................................................
Please confirm your consent by signing below.

Signed  						Date

If it becomes necessary for my child to be given urgent medical treatment and I cannot be contacted by telephone or any other means to authorise this, I hereby give my general consent to any medical treatment judged to be necessary and urgent by a medical practitioner and I authorise the leader in charge to sign any document required by hospital or other authorities.

Signed  							Date

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Additional permission for other ringing activities.

I also understand that when my child has reached a sufficient standard of proficiency in bellringing, he/she might find it beneficial to attend ringing events in other towers which are not part of the organised activities of Abingdon Society of Bellringers.
 
I give my permission for …………………………….. to make such visits and I accept that I am responsible for transporting my child to and from the venues for these activities, and that the group leaders at these events are not responsible when my child leaves the tower.

Signed  							Date

(N.B. The young person when attending these other events should carry a copy of this permission form together with the list of contact numbers and any relevant medical information.)