Kids Church 2024 • Parramatta Baptist Church

Thank you for taking time to provide us with current information on your child. We collect this information annually to ensure we are best caring for your child/s needs.

If you wish to provide information for multiple children, please fill the form out for one child then select the "please click to add another child" button.

If you have any questions about this process, please call (02) 9630 3515 to speak with the Kids Church team.

Thank you!

General Information

First Name *

Date of Birth *

Home Address *

Post Code *

Medicare Number

School *

Last Name *

School Grade *

Home City *

Home Number

Position on Medicare card

Parent's Email Address *

Medical Conditions: please list any medical conditions or allergies your child experiences *

Tip: Mark 'Nil' if no medication conditions

Medication or special care required (in relation to medical conditions) *

Tip: Mark 'Nil' if nothing to list

Is your child on a restricted diet?

Yes

If yes (on a restricted diet) please indicate foods or beverages your child should not consume.

Parental/Legal Guardian's information

Name of Parent/Legal Guardian (1) *

Name of Parent/Legal Guardian (2) *

Last Name *

In the case emergency, the church should first contact:

Emergency Contact Name *

Home Phone

Work Phone

Relationship To child *

Mobile Phone

Alternative Emergency Contact:

Emergency Contact Name *

Home Phone

Work phone

Relationship to Child *

Mobile Phone

Declaration

I authorise the leader in charge of my child's group to arrange for my child to receive first aid, medical or surgical treatment as may deem necessary at any time during the activities of Parramatta Baptist Church.

I further authorise the use of ambulance and/or anaesthetic by a qualified medical practitioner if in his/her judgement is necessary. I accept responsibility for payment of all expenses associated with such treatment.

I give permission for photos to be taken of my children to be displayed on noticeboards in the church and on a nametag worn by my child.

Declaration

By marking this box, I affirm the authorisations and permissions listed in the above declaration.

Your full name

Relation to Child

Today's date

Child Information Form

General Information

Parental/Legal Guardian's information

Declaration