Sunday Kids’ Programs

CHILD INFORMATION FORM

Child's name *

First

Last

Child's date of birth *

Child's address *

Address Line 1

Address Line 2

City/Suburb

Postcode

School *

School Year *

Parent/Carer 1 Details *

Name

Contact Number *

Email *

Relationship of 1 to child *

Parent/Carer 2 Details *

Name

Contact Number *

Email *

Relationship of 2 to child *

Emergency Contact if parent/carer not available *

Name

Contact Number *

Relationship to child *

Allergies *

Allergies not listed above

Treatment for allergic reaction

Other medical conditions *

Medical conditions not listed above

Managing the medical condition

Special Dietary Needs *

Dietary needs not listed above

Do you give permission for photos or videos of this child to be used in WRCC's marketing (website, print) *

Thank you for providing this important information. The safety and well-being of your child is our primary concern. Please update the Kids Ministry leaders if there are any changes to this information. During the program your child/ren will be supervised by the leaders who are screened and trained and have verified Working with Children Checks. By selecting OK you are giving permission for your child to attend the kids program run by West Ryde Community Church. *

OK
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