Kids/Youth Ministry Registration • Uralla Anglican

Privacy Declaration

St. John's Anglican church ,Uralla is exempt from the requirements of the policy act 1988(Cth) as it is a "small business". However, we seek to deal carefully with the personal information we collect and to do so in a manner consistent with your reasonable expectations.

The personal information in this form will be made available to:

the leaders involved in the running of the activities in which your child participates
emergency services when necessary

Parents Details

First Name

Last Name

Email Address

Phone Number

Mobile Number

Home Address

Home City

Home State

Home Zip Code

Emergency Contact

First Name

Last Name

Relationship to Child

Mobile Number

Medical Information

Medicare Number

Medicare expiry date

Ambulance cover

Authorisations and Expectations

I give permission for my children to attend all scheduled activities unless I advise the Vicar otherwise.

I give permission for photos or videos of my children taken at St. Johns Anglican, Uralla events to be displayed publicly (online and in print).

I give permission for my children to take paracetamol if required?

I authorise the kids and youth leaders, in the event of an emergency, to obtain at my expense any medical, ambulance, rescue or other services that are considered necessary for my children.

I will provide the Vicar with any information relevant to the wellbeing of my children prior to them attending an activity.

I acknowledge that being part of a community involves mutual care and consideration, and therefore agree that unacceptable behaviour may result in my children being sent home and being temporarily or permanently prohibited from attending the activities of St John's Anglican Church Uralla.

I confirm that the information given in this form is true and correct, and will advise the Vicar of any changes to this information

Child 1 Information

We will keep these details on file so that we do not have to ask for them prior to each event, unless you request otherwise. Please advise the Vicar as soon as practical of any changes to this information.

First Name

Last Name

Date of Birth

Gender

School

Grade

Position on Medicare card

Does your child have any medical conditions that we should know about?

Does your child have any needs that we should know about?

Does your child have any food allergies or special dietary needs that we should know about?

I want to register my child for the following ministries

Johnnos (Sunday Morning 0-yr6)

playpatch (0-Starting School)

Kids club (Kindy-yr6)

(If attending Uralla Central School) I give permission for my child to be picked up by the ministry leaders and take directly to the Church Hall

Child 2 Information

First Name

Last Name

Date of Birth

Gender

School

Grade

Position on card

Does your child have any medical conditions that we should know about?

Does your child have any needs that we should know about?

Does your child have any food allergies or special dietary needs that we should know about?

I want to register my child for the following ministries

Johnnos (Sunday Morning 0-yr 6)

PlayPatch (0-start of school)

Kids Club (kindy-yr 6)

(If attending Uralla Central School) I give permission for my child to be picked up by kids club leaders and take directly to the Church Hall

Child 3 Information

First Name

Last Name

Date of Birth

Gender

School

Grade

Position on card

Does your child have any medical conditions that we should know about?

Does your child have any needs that we should know about?

Does your child have any food allergies or special dietary needs that we should know about?

I want to register my child for the following ministries

Johnnos (Sunday Morning 0-yr 6)

PlayPatch (0-start of school)

Kids Club (kindy-yr 6)

(If attending Uralla Central School) I give permission for my child to be picked up by kids club leaders and take directly to the Church Hall

Child 4 Information

First Name

Last Name

Date of Birth

Gender

School

Grade

Position on card

Does your child have and medical conditions that we should know about?

Does your child have any needs that we should know about?

Does your child have any food allergies or special dietary needs that we should know about?

I want to register my child for the following ministries

Johnnos (Sunday Morning 0-yr 6)

PlayPatch (0-start of school)

Kids Club (kindy-yr 6)

(If attending Uralla Central School) I give permission for my child to be picked up by kids club leaders and take directly to the Church Hall

Child 5 Information

First Name

Last Name

Date of Birth

Gender

School

Grade

Position on card

Does your child have any medical conditions that we should know about?

Does your child have any needs that we should know about?

Does your child have any food allergies or special dietary needs that we should know about?

I want to register my child for the following ministries

Johnnos (Sunday Morning 0-yr 6)

PlayPatch (0-start of school)

Kids Club (kindy-yr 6)

(If attending Uralla Central School) I give permission for my child to be picked up by kids club leaders and take directly to the Church Hall