Emmanuel with St Paul's
serving Mannamead and Efford, Plymouth

Emmanuel (with St Paul's) Registration

Please take the time to register your details with us. If you are registering a child or young person, please fill out the form with their details, including the section 'For children & young people only'. You can add your name as parent/guardian in the Emergency Contact box.

Basic Details
Title:
* First Name:
* Last Name:
Date of birth:
/ / (dd/mm/yyyy)
Gender:
* Email Address:
Alternative Email Address:
Address
Line 1:
Line 2:
Town / City: City:
County: State:
Postcode: Zip code:
Phone Numbers
Mobile:
Home:
Work:
Privacy Settings
If I appear in the secure online address book, other members can see:
For children & young people only
List of children to appear in Yellow Pages (?) :
Please list any allergies (including foods) (?) :
Dietary requirements (other than allergies) (?) :
Please list any medical conditions or disabilities (?) :
Permission for publicity photos involving child (?) :
Permission to attend to child for minor injury? (?) :
Current School Year (if applicable) R, or 1-13 (?) :
Emergency Contact No. (if not listed in profile) (?) :
Registration
I would like to register for the following areas of the site:

Consent
Any Additional Information (optional)
Please include any additional notes or comments which would help us process your registration more quickly:

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