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West Ryde Community Church

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Personal Information Registration Form (Adult)

Your details

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Email *

Phone *

Date of birth *//

Emergency contact details

Contact Name *

First

Last

Contact Phone *

Contact relationship to you

Cultural background

This information helps us to respect and celebrate your cultural background. It also allows us to offer services that may be more relevant to you. This information is optional.

Country of Birth

Language spoken at home (other than English)

Family relationships

This information helps us to respect your family relationships and avoid any confusion or embarrassment. It also allows us to offer services that may be more relevant to you. Please ensure that separate forms for your spouse and children (if applicable) are completed. This information is optional.

Marital status

Spouse name

First

Last

Number of children under 18 years old

Child 1 name

First

Last

Child 2 name

First

Last

Child 3 name

First

Last

Child 4 name

First

Last

Special needs

This information helps us to respect and cater for your special needs. It also allows us to offer services that may be more relevant to you. Special needs include any physical, mental and social medical conditions and dietary restrictions that may impact your participation in ministries, activities and events.

Medical conditions

Dietary restrictions

Milk / Lactose Allergy or Intolerance
Egg Allergy or Intolerance
Shellfish Allergy or Intolerance
Peanut / Tree Nut Allergy or Intolerance
Wheat (Gluten) Allergy or Intolerance
Soybean Allergy or Intolerance
Vegetarian Diet
Vegan Diet
Kosher Diet
Halal Diet

Use of your personal information

This information lets us know how you want us to use your personal information.

Consents *

I give consent for my contact details and photo to be published in the church directory
I give consent for photos of me to be published in printed material including brochures and booklets
I give consent for photos or videos of me to be displayed within the church premises including on presentations, notice boards, banners and posters
I give consent for photos or videos of me to be published online including our website (https://www.westrydecc.org.au) and social media

Declaration

Declaration *

I certify that the supplied information is true and correct.

Declaration *

I give consent for my personal information to be used by WRCC for the purposes set out in our Privacy Policy.

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UPGRADE THANKS

With grant money from the City of Ryde we have replaced 9 non-compliant windows with safety glass and applied safety film to 14 other glass panels to meet Australian safety standards, improving safety.

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