On-Line Lesson Registration Form Parent / Guardian Name* First Last Parent / Guardian Email* Enter Email Confirm Email A student lesson account will be set-up using the parent/guardian email unless permission is given to use an alternate email for the student account. If an alternate student email is provided, all communication will be sent to that email.Alternate Student Email OptionalStudent InformationStudent Name* First Surname Date of Birth* DD slash MM slash YYYY Date of birth will be used to assign the student to the lesson level that is appropriate for their age.Male/FemaleN/AFemaleMaleNeed to enter details for another child? No Yes Student 2Student Name (S2) First Surname Date of Birth (S2)* DD slash MM slash YYYY Date of birth will be used to assign the student to the lesson level that is appropriate for their age.Male/Female (S2)N/AFemaleMaleWhat email should be used for student 2? Parent / Guardian email as listed above Alternate student email Alternate Email for Student 2 Need to enter details for a third child? No Yes Student 3Student Name (S3) First Surname Date of Birth (S3)* DD slash MM slash YYYY Date of birth will be used to assign the student to the lesson level that is appropriate for their age.Male/Female (S3)N/AFemaleMaleWhat email should be used for student 3? Parent / Guardian email as listed above Alternate student email Alternate Email for Student 3 Need to enter details for a fourth child? No Yes Student 4Student Name (S4) First Surname Date of Birth (S4) DD slash MM slash YYYY Date of birth will be used to assign the student to the lesson level that is appropriate for their age.Male/Female (S4)N/AFemaleMaleWhat email should be used for Student 4? Parent/Gaurdian email as listed above Alternate student email Alternate Email for Student 4 Postal Address No, I do not want to enter my postal address at this time Yes, I do want to enter my postal address If you wish for your child/children to receive birthday cards by post or communication about competitions and prizes by post, please check here and then enter your postal address.Address Street Address Address Line 2 City County Postal Code IrelandScotlandWalesOther Country PermissionsWe are committed to protecting any personal information provided to us. The information you enter will be used to provide services to you and your child. Please read our terms of membership and privacy policy.Membership Terms* I agree to the membership terms View Membership TermsI have read the terms of membership and give my permission for my child/children to join the National Bible Study Club.Consent* I agree to the privacy policy. View Privacy PolicyI give permission for the National Bible Study Club to hold my personal information and use it to communicate with me and my child.Parent / Guardian Signature*I certify that I am the parent / guardian of the above mentioned child / children.Today's Date* DD slash MM slash YYYY CAPTCHA Δ
