Holiday Kids Club - Registration Form 2024
Days Attending
*
Wednesday
Thursday
Friday
Family Funday Sunday 21 July 9am onwards includes church service, free lunch and fun activities
Carer's Details
Carer's First Name
*
Carer's Last Name
*
Mobile Number
*
Email Address
*
Mailing Address
*
Mailing City
*
Mailing State
*
Mailing Postcode
*
Church (if you currently attend one)
Alternative Emergency Contact Details
Alternative Emergency Contact - Full Name
*
Alternative Emergency Contact - please state their relationship to your child
*
Alternative Emergency Contact - Phone
*
Child's Details
Child's First Name
*
Child's Last Name
*
Gender
*
Male
Female
Date of Birth
*
School Grade (pre-school to Year 6 only)
*
-- None --
Nursery/Pre-school
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
Tip: Pre-school, K, 1, 2, 3, 4, 5 or 6 only
School
*
Allergies
*
Tip: If none, please write 'none'
Special Needs
*
Tip: If none, please write 'none'
Is there anyone restricted from contacting your child? If so please provide details.
*
Where did you hear about the kids club?
*
School
SRE at school
Church
Friend
Attended last year
Flyer
Website
Google
Playgroup
ESL Class
Youth Group
Other
Anything else you would like to tell us?
Parental Permission Terms & Conditions
*
I permit my child/children to attend the Holiday Kids' Club conducted in July 2024 by Yagoona Anglican Parish. I authorise the leader in charge of the Holiday Kids' Club, where it is impracticable to communicate with me, to arrange for my child to receive such medical treatment as the leader may deem necessary while in the care of the leader. I further authorise the use of an ambulance if in the leader's judgment it is necessary. I accept responsibility for payment of all expenses associated with such treatment.
Photos and videos
Photos/video will/may be taken during the course of the Holiday Kids' Club. I am willing for my child to be filmed/photographed in appropriate settings. I am also willing for these photos/footage to be used in the context of promoting the ministry (such as on a brochure for the group), without identifying their name or details.
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