Registration form for Youth/Children Activities 2025

This is an enduring permission form to be submitted annually by all youth and children who wish to participate in the activities run by Engadine and Heathcote Anglican Churches.

For any other questions or enquiries, please contact our Youth or Children's Ministers:

Youth - Daniel at: youth@eac.org.au

Children - Brodie at: Brodie@eac.org.au

Youth/Child's details

Please give us details below concerning your child that will enable us to best care for them in partnership with you.

First Name *

Date of Birth *

Last Name *

Biological Sex *

Street Address *

Suburb/City *

Postcode *

School Grade *

Primary School

High School

Medical Details

Does your child have any medical conditions that we should know about in order to care well for them? If so, please write in box provided, or otherwise write N/A.

Allergy/Medical Notes *

Anaphylaxis plan provided

Is there anything else we should know that will help us to care for your child?

Personal notes

Custody Details

Are there any Court Orders in place *

Notes (on court orders)

Are there any AVOs in place *

Notes (on AVO)

Parent/Guardian Information

Please give us details below concerning the primary carer of the youth/child that will enable us to best care for them in partnership with you.

* Primary means you will be our Primary contact

Primary Parent/Guardian First Name *

Primary Parent/Guardian Last Name *

Primary Parent/Guardian Mobile Number *

Primary Parent/Guardian Email Address *

Secondary Parent/Guardian First Name

Secondary Parent/Guardian Last Name

Secondary Parent/Guardian Mobile Number

Secondary Parent/Guardian Email Address

Emergency contact details

The emergency contact information you give below will be used when there is an emergency and we are unable to contact the primary or secondary parent/guardian.

Emergency Contact Name *

Emergency Contact Number *

Emergency contact relationship to child

Permissions

Do you give permission for your child's photo/video to be taken at Engadine and Heathcote Anglican Church events and displayed for an internal audience?

Photo Permission for internal use *

Do you give permission for your child's photo/video to be taken at Engadine and Heathcote Anglican Church events and displayed on our website and social media platforms?

Photo Permission to be displayed online *

Heathcote Kids Club only - Permission to be picked up from Heathcote Public school and taken to Kids plus Heathcote by Kids Club leader *

Please select activities you wish to give your child permission to attend.

Youth/Children's Ministries involved in *

Privacy Declaration

*I/we give permission for the personal details given herein to appropriate Engadine and Heathcote Anglican Church (EHAC) leaders and/or relevant supervisory/medical/emergency services personnel as deemed necessary

*I understand the details given herein will be used by EHAC leaders to contact myself, and that the details will not be given to any third party except as provided for above purposes

Authorisations and Expectations

* By completing this form, I/we hereby give permission for my child/ren to attend all scheduled EHAC activities, unless I/we explicitly advise the EHAC leadership otherwise.

*I/we as the parent guardian of the child/ren above give permission for them to travel during the ministry programs to and from Engadine Public School hall (across the road) under the supervision of their leaders.

* In doing so I/we undertake to provide the EHAC leaders with any information relevant to the wellbeing of my child/ren prior to them attending any and all scheduled EHAC activities.

* I/we understand that every effort will be made to provide a safe environment for my/our child/ren to participate in. However, in signing this form, I/we authorise the leaders, in the event of an emegency, to obtain at my/our expense, any medical, ambulance, rescue or other service considered necessary.

* I/we acknowledge that in the course of EHAC activities, appropriate photos or videos may be taken of my/our child/ren by authorised personnel and may be used for an internal audience and/or posted for an external audience (ie. EHAC website), unless I/we explicitly advise the EHAC leadership team otherwise.

* I/we acknowledge that being part of a community involves mutual care and consideration and therefore agree that unacceptable behaviour may result in my/our child/ren being sent home and/or being temporarily or permanently prohibited from attending this group.

* I confirm that the information provided in this form is true and correct, and will advise EHAC of any subsequent changes or additions.

* I declare that by ticking the box below that I am a parent or legal guardian of the child/ren detailed in this form, and that I agree to my child/ren attending and participating in the scheduled EHAC kids and youth activities in 2025 unless I/we explicitly advise the EHAC leadership otherwise. I am also agreeing to the 'privacy declaration' and 'authorisations and expectations' mentioned above.

Consent box *

Signature

Parent/Guardian Full Name *

Registration form received *

Tip: Today's date