Date & Time
21 July, 2025 8:30 AM - 3:00 PM
Type
Price
Quantity
Standard (individual)
Price
$20.00
Quantity
Standard (family)
Price
$50.00
Quantity
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Standard (individual)
0
Child Details
First Name
*
Last Name
*
Date of Birth
*
Gender
*
Male
Female
School Grade
*
-- None --
Nursery/Pre-school
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
School
*
Child Medical Details
What is this child allergic to?
What immediate treatment is required?
Dietary Requirements
Does any regular medication need to be given during the program? Please give details and timing. (Needs to be in packaging with drug name, expiry date, child's name, and passed to First Aid officer at check-in)
Parent/Guardian Details
Parent/Guardian Name
*
Parent/Guardian Phone
*
Parent/Guardian Email
*
Secondary Emergency Contact Name
*
Secondary Emergency Contact Phone
*
Is anyone restricted from seeing this child? If so, what is the person's name?
Late Pickup
I will require late pickup (5:30pm) for my child/ren due to work commitments
*
Yes
No
By checking this box, I agree that I will pickup my child/ren by 5:30pm
*
I agree
Permissions
I give permission for my child to have their photo/video taken, which may be used for promotional purposes (including published online/social media)
*
Yes
No
In the case of a medical emergency, I hereby give permission to the doctor chosen by the church authorities or other persons supervising or administering the children/youth activity, to secure proper treatment for and/or order hospitalisation, injection, anaesthetic, or surgery for my child as named. I understand that every effort will be made to contact me prior to instituting such procedures
*
Yes
Is there anything else we need to know?
Standard (family)
0
Child Details
First Name
*
Last Name
*
Date of Birth
*
Gender
*
Male
Female
School Grade
*
-- None --
Nursery/Pre-school
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
School
*
Child Medical Details
What is this child allergic to?
What immediate treatment is required?
Dietary Requirements
Does any regular medication need to be given during the program? Please give details and timing. (Needs to be in packaging with drug name, expiry date, child's name, and passed to First Aid officer at check-in)
Parent/Guardian Details
Parent/Guardian Name
*
Parent/Guardian Phone
*
Parent/Guardian Email
*
Secondary Emergency Contact Name
*
Secondary Emergency Contact Phone
*
Is anyone restricted from seeing this child? If so, what is the person's name?
Late Pickup
I will require late pickup (5:30pm) for my child/ren due to work commitments
*
Yes
No
By checking this box, I agree that I will pickup my child/ren by 5:30pm
*
I agree
Permissions
I give permission for my child to have their photo/video taken, which may be used for promotional purposes (including published online/social media)
*
Yes
No
In the case of a medical emergency, I hereby give permission to the doctor chosen by the church authorities or other persons supervising or administering the children/youth activity, to secure proper treatment for and/or order hospitalisation, injection, anaesthetic, or surgery for my child as named. I understand that every effort will be made to contact me prior to instituting such procedures
*
Yes
Is there anything else we need to know?
