Kids Registration Form (Medical / Emergency / Photo Consent)

 

Personal Details of the Child

Protecting your privacy is important to us. The information we seek allows us to manage risk, provide reasonable care and administer your child/young persons involvement in our program. We are careful to keep your information confidential, stored securely and provide it only to those agents acting on behalf of the church who need it to enable them to perform their agreed activities (e.g. a Team Member providing First Aid). We only ask for information that is necessary for the purposes outlined in this statement. In some circumstances, if you don't provide us with all requested information, your child/young person could miss the opportunity to be involved in our program. For more information please contact us (ph: 5231 1106, or email: cfccolac@gmail.com)

Contact Details

Medical Information

[Note: Any medicine/tablets needed during the time your child is registered in a church program should be handed in their original packaging to a Team Leader together with: name of child, dosage required & time and specific details of administration.]

[Note: Any medicine/tablets needed during the time your child is registered in a church program should be handed in their original packaging to a Team Leader together with: name of child, dosage required & time and specific details of administration.]

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Emergency Contacts (please complete at least two)

Release Forms

By signing this Medical Information form you understand/agree that:

  • Team Leaders for this program have your consent to take whatever action necessary to ensure the safety and wellbeing of the group or individual participants under their care (this includes your child). 

  • If your child becomes ill or is injured and you cannot or your nominated alternative emergency contact person(s) cannot be contacted, Team Leaders may obtain on your behalf whatever medical treatment is deemed necessary. You also agree to pay for such medical expenses.

  • If you fail or neglect to provide sufficient and current information in writing to enable the proper treatment of your child, no liability will be accepted for any injury or illness, which your child may suffer as a result.

  • Your childs own doctor or may be contacted in the case of any emergency. 

  • An ambulance may be called in the case of an emergency.

  • Should any of your childs medical information change you will inform us as soon as possible.

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We are requesting permission to take photographs or record video footage of your child for express use on publications, multi-media presentations or websites belonging to the church. As you are aware, there are potential dangers associated with the posting of personally identifiable information on a web site since global access to the Internet does not allow us to control who may access such information.  These dangers have always existed; however, we do want to celebrate your child and his/her experiences.  No personally identifiable information regarding your child will be published or provided to other organizations or individuals, except where this information is required by law, reporting suspected abuse or neglect, or in the case of an emergency. [Personally identifiable information includes: participant names, photo or image, residential address, email address or phone numbers.] If you, as Parent/Carer, wish to rescind this agreement, you may do so at any time.

For more information please contact us (ph: 5231 1106, or email: cfccolac@gmail.com)

Thank you for helping us care for your child.