Minto Anglican Youth and Kids Registration 2022 • Minto Anglican Church

Parent/Caregiver 1

This information will automatically fill for additional children below.

First Name *

Email Address *

Relationship to Child/ren *

Last Name *

Mobile Number *

Languages Spoken *

Parent/ Caregiver 2

This information will automatically fill for additional children below.

First Name

Email Address

Relationship to Child/ren

Last Name

Mobile Number

Languages Spoken

Emergency Contact

Alternative to parent/caregiver
This information will automatically fill for additional children below.

First Name *

Relationship to Child/ren *

Last Name *

Mobile Number *

Authority to Collect Child

In addition to the people (parents/ caregivers and emergency contact) listed above, I authorise the following people to sign in and sign out my child from any kids' ministry program at Minto Anglican Church.

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

Tip: Tip: If yes, please indicate who this is

Privacy Declaration

Minto Anglican Church is exempt from the Requirements of the Privacy Act 1988 (Cth) as it is 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:

the Kids and Youth leaders involved in the running of the activities in which my child participates, and
medical and emergency services if considered necessary

Authorisations & Expectations

I give permission for my child to attend all scheduled activities, unless I advise the Youth or Children's Minister otherwise I authorise the Kids or Youth 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 Minto Anglican Church I will provide the Youth or Children's Minister with any information relevant to the wellbeing of my child prior to him or her attending an activity I confirm that the information given in this form is true and correct, and will advise the Youth or Children's Minister of any changes to this information.

Parent/ Caregiver Authority

Yes, I agree to and authorise the above

Child

We will keep these details on file so that we do not have to ask for them prior to each event, unless you request otherwise. Please advise the Youth or Children's Minister as soon as practical of any changes to this information.

Personal Details

First Name *

Address *

Suburb *

Date of Birth *

School *

Last Name *

Postcode *

State *

Gender *

Grade *

For Youth Only (16 years or older)

Optional, for Youth Leaders to contact

Email Address

Mobile Phone

Programs Attending

Kids Church Sunday Morning

9am Crèche: 0 to 2 year olds

9am Infants: 3 year olds to year 1

9am Primary: Year 2 to year 6

11.15am Kids Church: 3 year olds to year 6

Sprouts Playgroup (Under 0 to 5 year olds & their carers)

Friday

Youth Programs

Minto Youth (Friday Night, Yr 6-12)

Authorisations

Photos and advertising

I give permission for photos or videos of my child taken at Minto Anglican Church events to be displayed publicly (online and in print) unless I advise the Youth or Children's Minister otherwise.

Yes, I agree

Medical Information

Medicare Number *

Position on Card *

Medicare Expiry Date *

Ambulance Cover *

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

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

If yes, please specify

Prescription medication

Chronic illness

Medical allergies

Other

Please provide further detail

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

If yes, please specify

Behavioural concerns

Psychiatric care

Other

Please provide further detail

Does your child have any food allergies or special dietary needs that we should know about? *

Please provide further detail