Kids and Youth Registration Form • Campbelltown Anglican

Campbelltown Anglican Churches Kids and Youth Ministry Registration Form

About YOU (parent/guardians)

Parent/Guardian One Name: *

Address:

Contact Number: *

Email Address:

Parent/Guardian Two Name:

Address:

Contact Number:

Email Address

Emergency Contact Information (NOT you or the second contact above)

Please provide the details of someone other than you.

Name of Emergency Contact Person: *

Contact Number: *

Relationship to you/your child:

Permissions

I give permission for photographs/video of my child/ren to be taken whilst at Campbelltown Anglican Churches by persons other than myself, and understand that these may be used for publicity and/or promotion of Campbelltown Anglican Churches Kids and Youth activities including on Facebook. *

Yes

I give permission for emergency medical attention to be administered to myself or my child where necessary. *

Yes

The information collected on this form will be used to contact you and care for you while you attend services and/or activities provided by Campbelltown Anglican Churches. It will be disclosed to Ministry Staff as required. It will be handled in accordance with our privacy policy. By submitting this form, you indicate your consent for us to collect, use and disclose the information you have provided above in this manner.

Campbelltown Anglican Churches Kids and Youth Ministry Registration Form

About YOU (parent/guardians)

About your Child/ren

Emergency Contact Information (NOT you or the second contact above)

Permissions