Child's Details - Age 2 to Grade 4
First Name
*
Last Name
*
Gender
Male
Female
Date of Birth
*
School Grade
*
-- None --
Kindergarten
Prep
1
2
3
4
5
6
7
8
9
10
11
12
Home Address
*
Home City
*
Home Postcode
*
Email Address
What school do you go to?
Parents or Guardians/Carers Information
Parent/Carer Name
*
Relationship to child
*
Mobile Number
*
Parent email
*
Address (if same as above please write ás above')
Emergency and Medical Info
Emergency Contact (other than parent/carer already listed)
*
Any allergies/health concerns or other important issues.
Any custody arrangments we should know
Kids Time Privacy Policy
I give permission for photos taken at Kids Time to be used for publicity such as church newsletters, church website or the church facebook
*
Yes
No
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