A safe & fun place for 8-14 year olds

Looking for a fun and safe way for your kids to spend their Friday nights? Come and check out our programme.

Kids from 8- 14 years old can come & get involved with games night’s, creative projects, sports and much more.

Places are limited so if you would like to register your young person please do so here.

The details you need

Location: Belfast City Mission, Island St, Belfast BT4 1GP

Time: 19:00 - 20:30

Cost: Free

Youth Club Form 2

Child's Name

First Name

Last Name

Date of birth

Please enter child's date of birth

YYYY

Parental Responsibility

Please give us the full names of the people who have parental responsibility for the child

Phone

Please supply phone numbers of the people listed above with parental responsibility

(###)

###

####

Address

Address where young person usually lives

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Health information

Please include any important health information that you feel we would need to know e.g. allergies, medication, health condition or disability etc.

GP Name & Address

Please give the name and address of practise for your child's registered GP

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Medical treatment

In an emergency and/or if I cannot be contacted, I am willing for my child to receive necessary hospital or dental treatment including an anaesthetic.

Yes

Permission : Photos/ Video content

I give permission for my child’s photograph/video to be taken (The photographs/videos will be used for church purposes only, including online publication, church magazines and press releases.)

Yes

Child's collection arrangements

The following pick up arrangements are in place for my child

I am happy for my child/children to walk home on their own

My child will be collected by myself or another adult

Declaration

I have downloaded and read the code of conduct for Exchange Youth Club and agree with the terms & conditions of entry.

Yes