You Are Welcome Here • Kingdom Makers Church

WELCOME TO KINGDOM MAKERS

First Name *

Last Name *

Suburb *

Gender *

Mobile Number *

Email Address *

Age Group *

CHILD/REN INFORMATION

Classes are based upon the age of your child: 18mths - Pre-prep; Prep - Grade 3; Grade 4 - Grade 6

CHILD DETAILS:

Full Name *

Date of Birth *

School *

School Grade *

Learning/Behavioral Difficulties *

Allergies? *

CHILDREN DETAILS:

Full Name *

Date of Birth *

School *

School Grade *

Learning/Behavioral Difficulties *

Allergies? *

Full Name *

Date of Birth *

School *

School Grade *

Learning/Behavioral Difficulties *

Allergies? *

CHILDREN DETAILS:

Full Name *

Date of Birth *

School *

School Grade *

Learning/Behavioral Difficulties *

Allergies? *

Full Name *

Date of Birth *

School *

School Grade *

Learning/Behavioral Difficulties *

Allergies? *

Full Name *

Date of Birth *

School *

School Grade *

Learning/Behavioral Difficulties *

Allergies? *

CHILDREN DETAILS:

Full Name *

Date of Birth *

School *

School Grade *

Learning/Behavioral Difficulties *

Allergies? *

Full Name *

Date of Birth *

School *

School Grade *

Learning/Behavioral Difficulties *

Allergies? *

Full Name *

Date of Birth *

School *

School Grade *

Learning/Behavioral Difficulties *

Allergies? *

Full Name *

Date of Birth *

School *

School Grade *

Learning/Behavioral Difficulties *

Allergies? *

CHILDREN DETAILS:

Full Name *

Date of Birth *

School *

School Grade *

Learning/Behavioral Difficulties *

Allergies? *

Full Name *

Date of Birth *

School *

School Grade *

Learning/Behavioral Difficulties *

Allergies? *

Full Name *

Date of Birth *

School *

School Grade *

Learning/Behavioral Difficulties *

Allergies? *

Full Name *

Date of Birth *

School *

School Grade *

Learning/Behavioral Difficulties *

Allergies? *

Full Name *

Date of Birth *

School *

School Grade *

Learning/Behavioral Difficulties *

Allergies? *

CHILDREN DETAILS:

Full Name *

Date of Birth *

School *

School Grade *

Learning/Behavioral Difficulties *

Allergies? *

Full Name *

Date of Birth *

School *

School Grade *

Learning/Behavioral Difficulties *

Allergies? *

Full Name *

Date of Birth *

School *

School Grade *

Learning/Behavioral Difficulties *

Allergies? *

Full Name *

Date of Birth *

School *

School Grade *

Learning/Behavioral Difficulties *

Allergies? *

Full Name *

Date of Birth *

School *

School Grade *

Learning/Behavioral Difficulties *

Allergies? *

Full Name *

Date of Birth *

School *

School Grade *

Learning/Behavioral Difficulties *

Allergies? *

PERMISSIONS

What is your relationship to child? *

Are there any custodial arrangements that we need to be aware of? *

PHOTOGRAPHY/VIDEO RECORDING

From time to time photographs and video recordings may be taken. This is a way of recording and displaying social events and the life of our Kids Ministries

Please select any of the following statements that applies:

Be photographed/videoed by authorised people

Have photograph and/or video shown within the church

Appear in the church newsletter, website and local press

KINGDOM MAKERS will not release the child to anyone (sibling, mother, father or grandparents - unless listed on this form)

By clicking SUBMIT:

You agree that all the information recorded on this form is collected and managed in accordance with the ACC Privacy Policy. *

Yes

You agree that this information has been collected for the primary purpose of the Kids Ministry *

Yes

You agree that this information maybe used for any activities conducted or promoted by Kingdom Makers Church. *

Yes

SUBMIT will be accepted as your virtual signature *

Yes