Week 2

Use this form to apply for a place at the following service:

Wednesday 13th January - 10.00 a.m. - Haxby - Holy Communion

Any changes to rules permitting communal worship will be advised on the website

This form is for one place only.   If you wish to attend with another member of your household a separate form needs to be submitted.


First name:*
Surname:*
Telephone number:*
Do you wish to attend this service with another member of your household? (If 'yes' a separate form needs to be submitted for them):*
Yes
No
If this service is fully booked which of the following options would you prefer? (choose one only):*
Place me on a reserve list for this service
Offer me a place at another service in the benefice on the Sunday
Offer me a place at another service during the week
Add my name to the list for this service the following week
None of the above
We are required for NHS Test and Trace purposes to hold your name and contact details for 21 days after the service you attend. Please indicate your consent to us passing on this information if needed. You may attend a service if you indicate 'no':*
I consent to you passing on my details if necessary
I do not consent to you passing on these details
Notifying you: please enter an e-mail address so we can let you know the outcome of your application:*
Please enter the verification number on the right:*
seven five six five three
* Required Fields