Childrens' Activities
Registration Form

All fields marked with * must be completed.

Parent/Guardian Information

First Name*

Last Name*

Parent/Guardian Information

Address Number and Street*

Address Town*

Address Postcode*

Parent/Guardian Information

Phone 1* (Mobile preferred)

Phone 2 (Optional)

Phone 3 (Optional)

Email*

Child's Information

Child's First Name*

Child's Last Name*

Languages Spoken at Home (Optional)

Child's Information

Child's Day of Birth*

Child's Month of Birth*

Child's Year of Birth*

Child's Information

Details of any medical condition your child has which we should be aware of:

Details of any Special Needs your child experiences:

Details of any allergies your child has:

Details of any special dietary requirements your child has:

If your child self-medicates then please ensure your child brings to every youth ministry meeting their inhaler, EpiPen, etc.

Please list the self-medication your child will bring with them:

Youth Ministry Information

Please check the following box, or boxes, next to the ministry your child will be attending*

Little Fishes [Rules]
For ages 0 to 4
Thursday, 9:15 – 11:15.

Little Fishes - Rules

Little Fishes is run by members of Hayes Town Chapel whose aim for the group is to provide a friendly environment for both adults and children to meet, while being able to introduce you and your family to simple Bible stories.

Little Fishes is open on Thursdays (Term Time only) from 9:45 to 11:15.

The time is structured into three mini sessions as follows:

• Free time for play and craft where there is tea/coffee/biscuits
• Bible story and songs where children have squash and a biscuit/fruit at roughly 10am
• Push-along play

It's a great opportunity for mums and dads (and grandparents) to bring their children (age 0-4) to a safe, happy and fun environment. We encourage parents to supervise their own children throughout the session to keep everyone safe and happy!

Cost. There's no set fee for Little Fishes - your generous donations are warmly appreciated and help us keep everything running!

Photographs. Photographs of children & adults are taken for display on the notice board. Please tick the relevant box in the child's registration form. Also, if you take any photos or videos please do not share them with others or on social media without the permission of all in the photo or video and their parents/guardians as appropriate.

Specific rules. You agree to take full responsibility for your children during Little Fishes.

Other activities at Hayes Town Chapel. If you would like information about any other activities at Hayes Town Chapel then please contact the General Information Mobile, 07310 045 655, to speak to one of the Elders. You are all welcome to our Family Service every Sunday morning at 11am and 6.30pm evening Service.

Judy Philpott
Little Fishes Leader

Stepping Stones [Rules]
For reception to year 3
Wednesday, 17:45 – 18:45.

Stepping Stones - Rules

Age group. The Hayes Town Chapel Stepping Stones is for children from nursery to Year 3 (4 to 8 year olds).

Timing and registration. The Club is held during school terms on Wednesday evenings from 5:45pm to 6:45pm. Please arrange for your child to arrive early for registration so that we can start the Club activities promptly. The register is held for the purpose of child protection, emergencies and acknowledging birthdays. Please advise the worker on registration if somebody else will be collecting your child at the end of the Club and confirm the password (any changes to the registration form to be in writing). At the end of the evening, please collect your child from the door of the church and escort them across the car park. If there are changes to the person picking up during club activities or another emergency please call the Building Mobile (only monitored during activities), 07310 045 655, to speak with a member of staff during the activity.

Activities for children. After registration, we have a play time with games and toys. The children are given a snack and drink to have during this time. After play time, we have a lesson time with Bible stories, songs and quizzes.

Activities for parents/guardians. After registration, parents and guardians are welcome to stay in the chapel and have tea or coffee in the foyer while the children have their activities. They can be in the foyer with their younger children or older children who are waiting for Junior Youth Club. Parents and guardians are responsible for these children who are not in Stepping Stones and should keep them in the foyer area.

Cost. There's no set fee for Stepping Stones - your generous donations are warmly appreciated and help us keep everything running!

Photographs. Photographs of the children are sometimes taken at particular Club events for display on the church notice board. If you take any photos or videos please do not share them with others or on social media without the permission of all in the photo or video and their parents/guardians as appropriate.

General. Please visit Stepping Stones to ask me for more details or to see what the children do. If you want your child(ren) to attend then please complete the registration form and return it to Hannah Newham at the Club on the first evening your child attends.

Specific rules. Please ensure your child is respectful to activity leaders and other children in the club.

Contacting Stepping Stones. While the Club is on, the Club leader can be reached in case of an emergency on 07310 045 655. However, outside the time of the Club this number is unmonitored. Any queries outside of this time should be through the main church number, 07310 045 655.

Other activities at Hayes Town Chapel. If you would like information about any other activities at Hayes Town Chapel then please contact the General Information Mobile, 07310 045 655, to speak to one of the Elders. You are all welcome to our Family Service every Sunday morning at 11am and 6.30pm evening Service.

Linda Birikorang
Stepping Stones Leader

Junior Club [Rules]
For years 4-6
Wednesday, 19:00 – 20:00.

Junior Club - Rules

Age group. The Hayes Town Chapel Junior Youth Club is for children from Year 4 to Year 6 (8 to 11 year olds).

Timing and registration. The Club is held during school terms on Wednesday evenings from 7:00pm to 8:00pm. Please arrange for your child to arrive early for registration so that we can start the Club activities promptly. The register is held for the purpose of child protection, emergencies and acknowledging birthdays. Please advise the worker on registration if somebody else will be collecting your child at the end of the Club and confirm the password (any changes to the registration form to be in writing). At the end of the evening, please collect your child from the door of the church and escort them across the car park. If there are changes to the person picking up during club activities or another emergency please call the Building Mobile (only monitored during activities), 07310 045 655, to speak with a member of staff during the activity.

Activities. The Club is a church youth club. After registration, we sing Christian songs and have a lesson from the Bible followed by craft and games. The craft may involve cooking or using clay, wood, paint or glue. Please ensure that your child wears suitable clothes and footwear (such as trainers). In the lighter evenings of the summer (weather permitting), we may take the children to Barra Hall Park to play games.

Cost. There's no set fee for Junior Club - your generous donations are warmly appreciated and help us keep everything running!

Valuable Property. Please ensure that your child does not bring valuable property (particularly mobile telephones) to the Club. The church has a mobile for emergencies. The Club will not be held responsible for loss or damage of personal property.

Photographs. Photographs of the children are sometimes taken at particular Club events for display on the church notice board. If you take any photos or videos please do not share them with others or on social media without the permission of all in the photo or video and their parents/guardians as appropriate.

General. Please visit the Club to ask me for more details or to see what the children do. If you want your child to attend then please complete general registration form and the tear off permission slip below and return it to Neil Russell at the Club on the first evening your child attends.

Contacting Junior Youth Club While the Club is on, the Club leader can be reached in case of an emergency on 07310 045 655. However, outside the time of the Club this number is unmonitored. Any queries outside of this time should be through the main church number, 07310 045 655.

Other activities at Hayes Town Chapel. If you would like information about any other activities at Hayes Town Chapel then please contact the General Information Mobile, 07310 045 655, to speak to one of the Elders. You are all welcome to our Family Service every Sunday morning at 11am and 6.30pm evening Service.

Neil Russell
Junior Club Leader

Youth Club [Rules]
For year 7 to age 17
Friday, 19:30 – 21:30.

Youth Club - Rules

Age group. The Hayes Town Chapel Youth Club is for children from Year 7 to Year 13 (11 to 18 year olds).

Timing and registration. Fridays (Term Time) 7:30pm – 9:30pm. Please arrange for your child to arrive early for registration so that we can start the Club activities promptly. The register is held for the purpose of child protection, emergencies and acknowledging birthdays. If your child is not allowed to walk home themselves and there are changes to the person picking up during club activities or another emergency please call the Building Mobile (only monitored during activities), 07310 045 655, to speak with a member of staff during the activity.

Activities. The club is a church youth club. After registration, we learn from the Bible having either a main talk or group discussions divided into two age groups. After learning from the Bible, the young people are free to hang out or participate in a number of games or activities (e.g., ball games, board games, musical instruments) which are set up in the chapel for them to enjoy. After the games and activities, we all gather together to see a film (age rating no higher than 12) which is divided and shown throughout a few weeks. The meeting ends with some questions and discussions about the film and then some final notices.

Outings. The club throughout the year goes on some outings (e.g., bowling, trampolining, Black Park). Separate forms and permissions slips will be given for each outing closer to the date of the outings.

Cost. The first evening attended at the Club is free. The subscription for subsequent evenings is 50p for each evening attended. The club also has a tuck shop during the games and activities time for which the young people can spend their money.

Photographs. Photographs of the children are sometimes taken at particular Club events for display on the church notice board. If you take any photos or videos please do not share them with others or on social media without the permission of all in the photo or video and their parents/guardians as appropriate.

General. Please visit the Club to ask me for more details or to see what the young people do. If you want your child(ren) to attend then please complete the general registration form ahead of the first evening your child attends.

Contacting Youth Club. While the Club is on, the Club leader can be reached in case of an emergency on 07310 045 655. However, outside the time of the Club this number is unmonitored. Any queries outside of this time should be through the main church number, 07310 045 655.

Other activities at Hayes Town Chapel. If you would like information about any other activities at Hayes Town Chapel then please contact the General Information Mobile, 07310 045 655, to speak to one of the Elders. You are all welcome to our Family Service every Sunday morning at 11am and 6.30pm evening Service.

Special Rules. Please read the following rules and conditions of Hayes Town Chapel's Youth Club. To maintain a friendly environment for games, activities and to provide an opportunity for children to learn about the Christian faith, these are the rules which all the children are expected to adhere to at all times whilst attending the Youth Club.

1. Children are registered and subs collected on arrival after 7:30pm. Any child deliberately arriving late, thereby missing the Bible study (at 7:40pm), 2 weeks in a row, will face a 1 week exclusion from the Youth Club.
2. If a child is disruptive during the Bible study or movie quiz/discussion times, they will be warned once. If a child is repetitively disruptive they will be asked to leave the Youth Club immediately for that particular evening. They are welcome to return following week.
3. Foul language and inappropriate conversation will not be tolerated. ie: The misuse of God's name and the name of our Lord Jesus Christ, swearing and language that is not acceptable.
4. We will allow no physical or verbal harassment of any nature at any time. This includes inappropriate or hurtful social media messages, sent between Members, that might be brought to the attention of the Youth Club Leadership Team. If your child should be the victim of this type of behaviour, via another Youth Club Member, the incident needs to be reported to the Youth Club Leadership Team immediately.
5. All leaders/workers are to be respected and obeyed at all times.
6. The equipment and property of the Youth Club is to be respected. Compensation may be required in regards to any costs incurred due to misuse and damage.
7. No drugs, alcohol, cigarettes, fireworks or weapons are to be brought onto the church premises.

Terms & Conditions.

1. Failing to comply with the above rules will result in the child being warned once only. If repeated, the child will be sent home or suspended, depending on the severity of the incident.
2. If your child wishes to leave at any point before closing time at 9:30pm, one of the Leadership Team must be notified by a parent or guardian through the Building mobile above.
3. As part of our weekly activities, we watch a section of a movie that will be completed over a number of weeks. These movies are carefully chosen by the leadership team for their potential to inspire the children and provoke thought and discussion. The highest age rating of the movies we choose is 12. If you would like to know the movie we are showing at any time, or would prefer that your child not to see a movie rated 12, please make this known to one of the leadership team.

Shaka Clarke
Youth Club Leader

Youth Ministry Rules

I have read and agree to be bound by the rules of the youth ministries to which I would like my child to attend*

Statement of Permission

Please check the following boxes where appropriate:

I give my permission for photographs to be taken of my child and/or me for use as display within the building.

I give my permission for my child to join club activities that take place in Barra Hall Park. Separate permission forms will be used for other activities taking place away from the church building.

I give my permission for my child’s birth date to be kept for birthday celebration in the youth ministry.

I give my permission for my contact details to be used by Hayes Town Chapel to provide additional information. Your contact details will not be passed on to third parties and you may change your answer at any time by informing the club leader.

Child Pick-Up

We are not responsible for the children before drop-off or after the club finishes. In the event of any other adult collecting your child(ren), please fill in their details and a password that they will be expected to know to authenticate them when collecting your child(ren):

Nominated Person 1 of 3: (Optional)

Full Name:

Relation to the child:

Password:

Nominated Person 2 of 3: (Optional)

Full Name:

Relation to the child:

Password:

Nominated Person 3 of 3: (Optional)

Full Name:

Relation to the child:

Password:

If attending the Youth Club, my child is allowed to leave by themselves and make their own way home. (Optional)

Parent/Guardian Signature

Parent/Guardian Full Name*:

Date of this Signature*:

Please ensure you come with your child on their first attendance so the activity leader can run over any questions on the form with you and confirm your electronic submission.