St Matts Kids Registration Form • St Matts West Pennant Hills

Thank you for filling in this form for your child/ren.

We are collecting this information to best care for your child and to keep you up to date with what's happening and what we are teaching them in our ministries. If you have any concerns please get in touch with us at kids@stmatts.org.au or view our privacy policy here.

Please choose which group(s) your child attends:

SUNDAY KIDS

Tiny Church (18 months-3 years)

Little Church (Preschool-Kindy)

Kids Church (Year 1 - Year 5)

FRIDAY KIDS

Kids Club (Yrs 3-6)

Child's Details

First Name *

Last Name *

Date of Birth *

Gender *

School *

School Grade *

Home Address *

Home City *

Mobile Number

Important information about your child

We want to be able to best care for your child. Please provide any helpful information below:

Allergies / medication / special diet / activity restrictions / behavioural issues *

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

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

Details of restrictions

Any additional information that will be helpful for us to care for your child

Photo information

Photos will be taken on occasion at our St Matts children’s activities.
Do you give consent for photos to be take of your child?

Picture Permission *

Yes

Photos may be used for advertising purposes.

I do not consent to photos of my child being used in church activities

I do not consent for photos of my child to be used to promote St Matts children's activities

Parent/Guardian #1

Parent #1 Full Name *

Parent #1 Phone *

Parent #1 Email *

Address (if different from above)

Parent/Guardian #2

Parent #2 Full Name

Parent #2 Phone

Parent #2 Email

Emergency Contact Information

Not the Parent/Guardian listed above

Emergency Contact Name *

Emergency Contact Mobile *

Permission

PARENTS PLEASE READ, SIGN AND DATE THE FOLLOWING:

My signature below indicates my willingness to permit my child:
• to participate fully in children’s programs within the parish church of St Matthew’s Anglican Church, West
Pennant Hills.
• 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’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.

PARENT OR GUARDIAN’S SIGNATURE CERTIFYING ACCEPTANCE OF ALL THESE CONDITIONS

Parent/Guardian Name *

Date signed *

The leadership team of the aforementioned group will treat the information contained confidentially. This information may be
shared with a third party when it concerns medical health or care of the individuals listed. If you wish to access this information or
have any queries in relation to the manner in which we handle your personal information, please do not hesitate to contact us.