KC24 Weekly Kids Club REGO • Hope Anglican Church

REGISTRATION FORM

Weekly Kids' Club 2024

To be completed for all children who attend Weekly Kids' Club at Hope Anglican Church and at least one parent/carer.

Registration is effective from 26th July 2024 to 20th December 2024 in relation to the activities indicated in the personal details section below.

Please ensure that you provide the details for:

at least one parent/caregiver AND
all children who attend.

PLEASE SELECT: Child OR Parent/Caregiver

Tip: Please select which person to provide details about. You can select 'add another parent or child' at the bottom. Please ensure that you provide the details for at least one parent/caregiver AND one child.

Personal Details

First Name *

Last Name *

Date of Birth *

Gender *

Email Address *

Mobile Number *

School *

School Grade

If your child attends Leppington Anglican College, we can pick them up from school and walk them over to Weekly Kids' Club, with your permission.

Home Address *

Home Suburb *

Home State *

Home Postcode *

Emergency Contact (alternative to parent/caregiver)

Full name *

Mobile *

Relationship to child *

Legal details

Is there anyone who is legally restricted from seeing your child? *

Yes

Please provide the names of anyone legally restricted from seeing your child below. *

Please email copies of any supporting documentation (eg: AVO or Family Court Order) to the Kids Church Pastor, Sarah Fitzpatrick: sarah@hopeanglicanchurch.org

Medical Details

Medicare Number *

Medicare Card Reference Number *

Medicare expiry number *

Do you give permission for your child to take paracetamol if required? *

Yes

Does your child have any allergies that we should know about? *

Yes

Allergies (Other)

Does your child have any medical conditions or care needs that we should know about? *

Yes

Please provide further information *

Authorisations

Please tick if you agree:

I do NOT give permission for photos/videos of my child taken at Holiday Kids' Club and other relevant events connected to this ministry to be displayed publicly (online and in print) and used in marketing materials (including website and social media platforms).

Authorisations & Expectations

I give permission for my child to attend all scheduled Weekly Kids' Club activities, unless I advise the relevant leaders otherwise.
I authorise the Weekly Kids' Club leaders, in the event of an emergency, to obtain at my expense any medical, ambulance, rescue or other services that are considered necessary for my child.
I acknowledge that being part of a community involves mutual care and consideration, and therefore agree that unacceptable behaviour may result in my child being sent home and being temporarily or permanently prohibited from attending the activities of Weekly Kids' Club.
I will provide the Weekly Kids' Club leaders with any information relevant to the wellbeing of my child prior to him or her attending a Weekly Kids' Club activity. This might include supporting documentation (eg: AVO, Family Court Order) if there is anyone who is legally restricted from seeing your child.
I confirm that the information given in this form is true and correct; and will advise Kids' Pastor at Hope Anglican Church of any changes to this information.
By submitting this registration form I agree to the above.

If you have any questions about this permission form, please contact Sarah Fitzpatrick at Hope Anglican Church via sarah@hopeanglicanchurch.org

Privacy Declaration

Hope Anglican Church is exempt from the requirements of the Privacy Act 1988 (Cth) as it falls under the same category as a small business. However, we seek to deal carefully with the personal information we collect and to do so in a manner consistent with your reasonable expectations.

The personal information in this form will be made available to

(a) the relevant leaders and members of Hope Church staff involved in the running of the activities in which my child participates, and

(b) medical and emergency services if considered necessary.