Contact Preferences Form


* Name:*
Address:
Home Phone Number:
Mobile Phone Number:
* Email address:*
Birthday in DD/MM format e.g. 01/06 = 1st June:
Consent. I give my consent for my: to be included in the Church Directory:
Name
Address
Home Phone Number
Mobile Phone Number
Email Address
Birthday
Lists and Prayer Diary. Please indicate by ticking which list(s) you would like to be included in::
All Email List - this is the email that goes to All members e.g. Notices
Prayer Email List
Prayer Diary
Birthday List
One Chapter a Day Email
One Chapter a Day WhatsApp Group
* Adult section completed:*
Please tick the box to show that you have completed the sections above. Now, either continue and fill the details for your child/children or go to the end of the form to the Signature section.
Parental Consent:
As a parent/guardian of my child/children, I consent to their data being held.
Child's Name:
Child's birhday (in the DD/MM format):
Child's name:
Child's birhday (in the DD/MM format):
Child's name:
Child's birhday (in the DD/MM format):
Child's name:
Child's birhday (in the DD/MM format):
Child's name:
Child's birhday (in the DD/MM format):
Child's name:
Child's birhday (in the DD/MM format):
* 'Signature':*
I understand that my consent is required for my information to be included in the Church Directory.
Please enter the verification number on the right:*
seven five six five three
* Required Fields