Kids Church Registration 2024 • St James Anglican Church Kununurra

Kids Church Registration Form

Hi there,

A parent or guardian needs to complete this form.

Thank you for filling out this form so that we are better able to care for your child and conform with Duty of Care regulations. Health information and some family details can be sensitive and will be kept confidential.

Please complete one form for each child being registered.

Please contact me if you have any questions.

In Christ,

Henry

Child's Details

First Name *

Last Name *

Gender

Date of Birth

School Grade

Health & Dietary Requirements

Allergies/Intolerances

Tip: You only need to write something here if your child has any allergies or intolerances.

Other Important details

Photography/ Video Permission Kids Church

I give permission for photos of my child to be used to advertise Kids Church within church.

I give permission for photos of my child to be used to advertise Kids Church to be used on church website/Facebook

Are there any access restrictions to your child (if yes, then Henry will contact you to find out details) *

Parent / Guardian Details

Parent / Guardian Full Name *

Mobile Number *

Email Address *

Mailing Address

Tip: Your PO Box is all that is required in this section

Permission to participate

Indicating yes on the drop down menu below indicates:

My willingness to permit my child to participate fully in the activities of Kids Church at St James Anglican Church Kununurra on Sundays.

Selecting Yes below certifies acceptance of the above.

Permission Given *

Date Registration Form Completed *

Do you have anything else you want to add about your child so that the team can best care for your child?

Thank you for filling in the form.

The Kids Church Team will treat all the information contained confidentially. This information may be shared with a third party when it concerns medical health or care of the individuals listed. Please don’t hesitate to contact Henry (Assistant Minister) with any questions.