Winterfest

Child (K-6) 0

Ticket Type

Child's Details

First Name *

Last Name *

Date of Birth *

Mailing Address

Does this person have allergies? *

Yes

Is this person on a special diet? *

Yes

Does this person suffer from asthma? *

Yes

Details of allergies / medication / special diet / activity restrictions / behavioural issues

Gender *

School Grade *

School *

Name a friend who your child would like to be in a group with

Tip: we will try our best to accommodate all requests

Is there anyone who is legally restricted from seeing your child?

Is there any other medical info?

Yes

Emergency Contacts Details

Emergency Contact 1

EC Full Name #1 *

EC Number #1 *

#1 Relationship to Child *

Emergency Contact 2

EC Full Name #2 *

EC Number #2 *

#2 Relationship to Child *

Permissions

PARENTS PLEASE READ, SIGN AND DATE THE FOLLOWING:

My name below indicates that:

I permit my child to participate fully in the Winterfest program associated with the St Matthews Anglican Church West Pennant Hills at the corner of New Line Road and Castle Hill Roads, on Monday 14 July - Friday 18 July 2025, from 9:00am - 1:00p.m.

In the case of a medical emergency, and a parent cannot be contacted, I hereby give permission to the doctor chosen by the church authorities or other persons supervising or administering the children’s 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.

I understand there will/may be photographs and or video footage of my child taken during the program to promote the ministry.

PARENT OR GUARDIANS NAME BELOW CERTIFIES ACCEPTANCE OF ALL THESE CONDITIONS.

Parent/Guardian Full Name *

Email Address *

Contact Number *