Children’s Program Enrolment 2024 Tue, 02/09/2021 - 15:24 | Steve Child's Full Name * Child’s Date of Birth * Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year2004200520062007200820092010201120122013201420152016201720182019202020212022202320242025 Grade Enter school grade level if applicable Gender * Male Female Program * Freeway Kids (includes Junior kids) Toddler to Grade 5 Youth (Grade 6-High school students Medical Condition / Allergy Details Please provide details of any medical conditions or allergies that we need to be aware of. Physical or Special Needs Does your child have any physical or special needs? if so, please enter details. Indigenous? Are you of Aboriginal or Torres Strait Islander origin? Yes NO Cultural requirements? Are there any cultural requirements we need to be aware of? if so, please enter details. Parent or Guardian Details Parent / Guardian * Relationship * Address * Mobile Phone. * Home Phone Email Address * Person(s) barred from contact Please give details of a) any person/s not permitted to contact or collect your child/ren while in the care of the above named group and b) any Court order related to such: PARTICIPATION I consent to my child becoming a member of Freeway Kids or Youth. I will encourage my child to attend and participate regularly and to cooperate with the leaders and other children. MEDICAL PERMISSION Children should not be left in Freeway Kids without a parent or family member present in the Church building but in the event of my absence I authorize the leaders in charge of Freeway Kids or Youth to arrange for my child to receive such first aid, medical or surgical treatment as the leader may deem necessary at any time during the activities. I further authorise the use of Ambulance and/or anesthetic by a qualified medical practitioner if in his/her judgment it is necessary. I accept responsibility for payment of all expenses associated with such treatment. INDEMNITY I agree to indemnify and hold harmless the Baptist Union of Victoria and Freeway Baptist Church against all claims, demands, suits and liability of whatever nature and howsoever arising out of the injury to the child, and the relevant activity being undertaken. PHOTO PERMISSION Photo Permission (Internal) * Indicate if you give permission for your child to be photographed and/or recorded during the course of the activity for the purposes of creating promotional material for use inside the church service. Yes, I give permission for my child to be photographed for use INSIDE THE CHURCH SERVICE NO, I do not give permission for my child to be photographed for use INSIDE THE CHURCH SERVICE Photo Permission (External) * Please indicate if you give permission for your child to be photographed and/or recorded during the course of the activity for the purposes of creating promotional material for use on the Church Website or Church related Social media. Yes, I give permission for use of my child's image on the CHURCH WEBSITE or CHURCH RELATED SOCIAL MEDIA NO, I do not give permission for use of my child's image on the CHURCH WEBSITE or CHURCH RELATED SOCIAL MEDIA By Clicking the SUBMIT button below you agree to the above as of today.
