Kids Church Registration | GospelLife Church Adelaide

Name (Required)

Email Address (Required)

Personal Details (Child)

Family Name/s (Required)

Name of Child (Required)

Preferred Name

Date of Birth (Required)

Parent(s)/Caregiver(s) Details

Name (Required)

Relationship to Child (Required)

Phone Number (Required)

Name

Relationship to Child

Phone Number

Special Situations/ Needs

Are there any family situations we should be aware of ? Eg: custodial issues, other matters (please specify)

Are there any special needs that your child may have that would be helpful for us to be aware of ? (please specify)

Permission

Permission to Participate in Program Activities (Required)

I consent to my child taking part in the approved program of activities for the GospelLife Church Adelaide Kids. I consent to my child viewing videos or DVDs rated (G) General. I understand that all material will be previewed by a leader to check suitability.

Permission for Returning to Church in Main Auditorium (Required)

I give permission for a GospelLife Kids Leader to return my child to the congregation at the conclusion of the service and visually sight and sign off on their return to me in the main auditorium. If my child is over the age of 8, I consent for my child to be dismissed from the Big League and independently return to me in the Auditorium near the conclusion of the service.

Confidential Medical Report

The information below is requested to assist in case of any illness or accident. This information will be held in confidence.

Please tick if your child suffers from any of the following: (Required)

Heart Condition

Blackouts

Asthma

Sleepwalking

Diabetes

Other

None

If 'Other', please specify

Is your child presently taking medication? (Required)

If yes, please state the name of the medication, dosage, etc.

Does your child self-administer?

Is your child allergic to: (Required)

Penicillin

Bee Stings

Other drugs or food

None

If 'Other drugs or food', please specify

Please list any physical or special needs: (eg. Dietary requirements)

Authorisation

Authorisation (Required)

I authorise the leader/s in charge of the above mentioned group where it is impractical to communicate with me, to arrange for my child to receive such medical or surgical treatment as the leader/s may deem necessary at any time during the activities of GospelLife Church Adelaide. I further authorise the use of Ambulance and/or anaesthetic by a qualified medical practitioner if in his/her judgement it is necessary. I accept responsibility for payment of all expenses associated with such treatment. I appreciate that every care will be taken by the leaders and those connected with that group cannot be held responsible for personal injury, loss or theft of property affecting my child.

Any other notes or comments you think may be relevant