Events / Creche Booking – Greenbank Masjid

Select Event

Name of parent / guardian *

Email Address *

Contact number *This will also be used in case of emergency

How many children are you registering? *

Name of child 1 *

Age of child 1 *

Child 1: Allergies / medical conditions *Are there any allergies or medical conditions we need to be aware of?

Name of child 2 *

Age of child 2 *

Child 2: Allergies / medical conditions *Are there any allergies or medical conditions we need to be aware of?

Name of child 3 *

Age of child 3 *

Child 3: Allergies / medical conditions *Are there any allergies or medical conditions we need to be aware of?

Cost

Consent *

By submitting this application, I, the parent/guardian of the child(ren) listed, agree to the following terms:

Medical Consent: I authorise the crèche staff to seek emergency medical treatment for my child if deemed necessary. I understand that all efforts will be made to contact me before such action is taken.
Liability Waiver: I acknowledge that participation in crèche activities involves inherent risks. I agree to release and hold harmless Easton Islami Darasgah (also known as Greenbank Masjid) and its staff from any claims arising from my child’s participation in the crèche, except in cases of gross negligence.
Behaviour Agreement: I understand that my child is expected to behave appropriately and follow crèche rules. I acknowledge that the crèche reserves the right to remove my child from activities if their behaviour is disruptive or poses a safety risk.
Health Declaration: I confirm that the health information provided for my child is accurate and complete. I agree to notify crèche staff of any changes to my child’s health status prior to the event.
Personal Items: I understand that Easton Islami Darasgah (Greenbank Masjid) is not responsible for lost, stolen, or damaged personal items brought to the crèche.
Collection Authorisation: I agree to collect my child promptly at the agreed-upon time. I understand that only authorised individuals listed on this form will be allowed to collect my child.