Rugeley Community Church

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Kidz Klub

Kidz Klub is a free, fun-filled, weekly gatherings for children, ages 5 to 12, in the community. Our meetings include snacks, games, worship, and interactive Bible lessons.

A snack will be provided, including sandwich, fruit, crisps, chocolate and squash drink. Please let us know if there are any dietary requirements.

Please fill in the details below and let us know which days your child will attend.

Times:

Dropoff: 3:30pm – 4:00pm
Pickup: 5:00pm

Registration Form

Guardian's full name

Email address

Mobile number

Address and post code

If you would like other people to be able to collect your children, please list their names here

How many children will be attending?

One Two Three Four

Full name (Child #1)

This child likes to be called... (Child #1)

Date of birth (Child #1) - Please specify DAY/MONTH/YEAR

Disabilities, medical conditions or medications? (Child #1)

Dietary information: Any allergies or food intolerances? (Child #1)

Which dates would you like for this child to attend? (Child #1)

June 14th June 21st June 28th July 5th

Full name (Child #2)

This child likes to be called... (Child #2)

Date of birth (Child #2) - Please specify DAY/MONTH/YEAR

Disabilities, medical conditions or medications? (Child #2)

Dietary information: Any allergies or food intolerances? (Child #2)

Which dates would you like for this child to attend? (Child #2)

June 14th June 21st June 28th July 5th

Full name (Child #3)

This child likes to be called... (Child #3)

Date of birth (Child #3) - Please specify DAY/MONTH/YEAR

Disabilities, medical conditions or medications? (Child #3)

Dietary information: Any allergies or food intolerances? (Child #3)

Which dates would you like for this child to attend? (Child #3)

June 14th June 21st June 28th July 5th

Full name (Child #4)

This child likes to be called... (Child #4)

Date of birth (Child #4) - Please specify DAY/MONTH/YEAR

Disabilities, medical conditions or medications? (Child #4)

Dietary information: Any allergies or food intolerances? (Child #4)

Which dates would you like for this child to attend? (Child #4)

June 14th June 21st June 28th July 5th

Guardian please make a note of the dates and times you have requested.

Comments: Do you have any additional comments that you would like to add?

Human test (blank is good)

Additional Preferences

I give permission for my child(ren) to have their photo taken for promotional purposes.

May we contact you about future Kidz Klub events?

I give permission for you to contact me about future Kidz Klub events.

GDPR Agreement

I allow Kidz Klub, part of Rugeley Community Church, to store and process the information submitted to respond to my enquiry.**

Thank you, we've received your message. You will receive an email in a few days to confirm your child's place. Please check your spam folder before contacting us.

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OFFICE HOURS

WEEKDAYS, 9am-4pm

Rugeley Community Centre,
Burnthill Lane,
Rugeley WS15 2HX
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GET IN TOUCH

CONTACT

Tel: 01889 579341
Email us
Or drop in for a chat at the
Centre

CHURCH

SUNDAYS 10:30am

Rugeley Community Centre,
Burnthill Lane,
Rugeley WS15 2HX
Find out more

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Rugeley Community Church is a registered charity no. 1152303, and a company limited by guarantee, registered in England no. 08341226. Registered office address: Rugeley Community Centre, Burnthill Lane, Rugeley, Staffordshire, England, WS15 2HX

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