Child Registration Form

Child's details.

This information is essential and needs to be updated every year

First Name *

Last Name *

Preferred Name *

Date of Birth *

Phone Number

Tip: Home number, this allows us to ensure that the right person's details are being updated.

Mobile Number

Email Address (enter the best email for contact purposes) *

Parent E-mail Address *

Home Address *

Home City *

Home Postcode *

Gender *

School Grade

Tip: This is automatically changed on 1 January.

School *

Child Information

Ministries Approved for the Child

Transport Approved for the Child

Communications & Social Media Approved for the Child

Photography Approved for the Child

Custody Issues

Are there any custody issues/ people prohibited from seeing the child.

Name of Emergency Contact

Best Contact Number

Relationship to Child

Alternate Contact

Best Contact Number for Alternate Contact

Medicare Number

Position on Medicare Card

Child Medical Note 1 - Critical issues

Child Medical Note 2 - Allergies & Intolerances

Child Medical Note 3 - Other health/behaviour issues

Medical Advice for Child

Pain relief *

Leaders can give paracetamol (eg Panadol)

Leaders can give ibuprofen (eg Nurophen)

Child Care/Info Leader Notes

Privacy Declaration

Please read the following information and check the tick boxes

I give permission for the personal details given herein to be provided to appropriate leaders and/or relevant medical/emergency services as deemed necessary.

I understand the details given herein will be used by leaders to contact myself and/or my child/ren and that the details will not be given to any third party, except as provided above.

Privacy Declaration *

By completing this form, I hereby give permission for my child/ren to attend all scheduled activities this year, unless we explicitly advise the leadership team otherwise. In doing so I undertake to provide the leaders with any information relevant to the wellbeing of my child/ren prior to them attending any and all scheduled activities.

I understand that every effort will be made to provide a safe environment, however in signing this form I authorise the leaders, in the event of an emergency, to obtain at my expense any medical, ambulance, rescue or other services considered necessary. I also acknowledge that being part of a community involves mutual care and consideration, and therefore agree that unacceptable behaviour may result in my child/ren being sent home &/or being temporarily or permanently prohibited from attending the activities of this group.

Form Declaration *