Online Registration

Family Name

Address

Post Code

Phone Number

New Parishioner New ParishionerYesNo

Please enter the details of all the people residing in the household

Person 1:

Person 1 Title

Person 1 Christian Name

Person 1 Date of Birth

Person 1 Occupation

Person 1 Religion

Person 1 Email (Over 18's Only)

Person 1 Mobile No. (Over 18's Only)

Person 2:

Person 2 Title

Person 2 Christian Name

Person 2 Date of Birth

Person 2 Occupation

Person 2 Religion

Person 2 Email (Over 18's Only)

Person 2 Mobile No. (Over 18's Only)

Person 3:

Person 3 Title

Person 3 Christian Name

Person 3 Date of Birth

Person 3 Occupation

Person 3 Religion

Person 3 Email (Over 18's Only)

Person 3 Mobile No. (Over 18's Only)

Person 4:

Person 4 Title

Person 4 Christian Name

Person 4 Date of Birth

Person 4 Religion

Person 4 Occupation

Person 4 Email (Over 18's Only)

Person 4 Mobile No. (Over 18's Only)

Person 5:

Person 5 Title

Person 5 Christian Name

Person 5 Date of Birth

Person 5 Religion

Person 5 Occupation

Person 5 Email (Over 18's Only)

Person 5 Mobile No. (Over 18's Only)

Person 6:

Person 6 Title

Person 6 Christian Name

Person 6 Date of Birth

Person 6 Religion

Person 6 Occupation

Person 6 Mobile No. (Over 18's Only)

Person 6 Email (Over 18's Only)

Parish Communications

We would very much like to keep you informed about parish events and services. Please tick the appropriate box. You do not have to give consent. Where you do not give consent we will not be able to use your personal data (for example to let you know about forthcoming services, events & fundraising initiatives) except in certain limited situations, such as where we are required to do so by law.

Consent Yes Consent Yes I/We consent to the Diocese of Brentwood and the Parish of St. Teresa of Lisieux contacting me to keep me informed about the news, events, fund raising and activities in my Parish and in my Diocese

Consent No Consent No I/We do not give consent

Use of pictures at parish events

From time to time we wish to take photos at parish events. These images may be used by the parish of St. Teresa of Lisieux Church in the following ways: Our printed publicity, Our website write-up of the events and to publicise follow up / similar events, Shared with members of the parish for personal use only.

These photos will be stored securely and deleted when no longer required. Names will not be linked to the images used. Permission granted covers all the named individuals on this form. Please tick the appropriate box

Consent Yes Consent Yes I/We grant permission for any images taken to be used as described

Consent No Consent No I/We would prefer for any images taken not to be used as described

Helping the church financially: I want help the parish financially by

Please tick Please tick Setting up a standing order Planned giving by envelope Gift aid my offering Increase my current offering

I Confirm that all the individuals on this form have agreed for this information to be provided to the Parish

Online Signature (If available)

Name

Date

Family Name

Address

Post Code

Phone Number

New Parishioner New ParishionerYesNo

Please enter the details of all the people residing in the household

Person 1:

Person 1 Title

Person 1 Christian Name

Person 1 Date of Birth

Person 1 Occupation

Person 1 Religion

Person 1 Email (Over 18)

Person 1 Mobile (Over 18)

Person 2:

Person 2 Title

Person 2 Christian Name

Person 2 Date of Birth

Person 2 Occupation

Person 2 Religion

Person 2 Email (Over 18)

Person 2 Mobile (Over 18)

Person 3:

Person 3 Title

Person 3 Christian Name

Person 3 Date of Birth

Person 3 Occupation

Person 3 Religion

Person 3 Email (Over 18)

Person 3 Mobile (Over 18)

Person 4:

Person 4 Title

Person 4 Christian Name

Person 4 Date of Birth

Person 4 Religion

Person 4 Occupation

Person 4 Email (Over 18)

Person 4 Mobile (Over 18)

Person 5:

Person 5 Title

Person 5 Christian Name

Person 5 Date of Birth

Person 5 Religion

Person 5 Occupation

Person 5 Email (Over 18)

Person 5 Mobile (Over 18)

Person 6:

Person 6 Title

Person 6 Christian Name

Person 6 Date of Birth

Person 6 Religion

Person 6 Occupation

Person 6 Mobile (Over 18)

Person 6 Email (Over 18)

Parish Communications

We would very much like to keep you informed about parish events and services. Please tick the appropriate box.

You do not have to give consent. Where you do not give consent we will not be able to use your personal data.

(for example to let you know about forthcoming services, events & fundraising initiatives)

except in certain limited situations, such as where we are required to do so by law.

Consent Yes Consent Yes I/We consent to the Diocese of Brentwood and the Parish of St. Teresa of Lisieux contacting me to keep me informed about the news, events, fund raising and activities in my Parish and in my Diocese

Consent No Consent No I/We do not give consent

Use of pictures at parish events.

From time to time we wish to take photos at parish events.

These images may be used by the parish of St. Teresa of Lisieux Church in the following ways:

Our printed publicity,

Shared with members of the parish for personal use only.

Our website write-up of the events and to publicise follow up / similar events,

These photos will be stored securely and deleted when no longer required.

Names will not be linked to the images used.

Permission granted covers all the named individuals on this form. Please tick the appropriate box

Consent Yes Consent Yes I/We grant permission for any images taken to be used as described

Consent No Consent No I/We would prefer for any images taken not to be used as described

Helping the church financially: I want help the parish financially by

Please tick Please tick Setting up a standing order Planned giving by envelope Gift aid my offering Increase my current offering

I Confirm that all the individuals on this form have agreed for this information to be provided to the Parish

Online Signature (If available)

Name

Date