PLUS56 Permission Form • Pennant Hills Baptist Church

PLU56 Kids Registration Form

PLU5/6 is happening every Friday afternoon from 4pm - 6pm during school term at one of our church member's place. Once you register your child, we will send out the address to you. Please note that this gathering is for Yr 5 and Yr 6 kids only.

To best care for our children at PLU56 we ask you fill out this confidential form below. We need to make sure our data base is updated with the correct contact and medical information to insure their safety.

Please fill out one registration per child. You may use the 'add another person button' at the bottom of the page to register another child from the same family.

Child's Personal Information

First Name *

Last Name *

Gender *

Date of Birth *

Home Address *

Home Address Line 2

Home State

Home Postcode *

School Grade *

School

Emergency Contacts

Parent/Guardian 1

First Name *

Last Name *

Phone Number *

Email Address *

Relationship to Child *

Parent/Guardian 2

First Name

Last Name

Phone Number

Email Address

Relationship to Child

Permissions

Do you consent for your child to participate in PLU56 Kids Activities and be involved in the program? *

Yes

Do you consent to the appropriate use by Pennant Hills Baptist Church of photographs and videos taken at PLU56 that include your child? *

Yes

Do you consent to your child travelling in a leader's car, following the Safe Church policy, for emergency situations? *

Yes

Do you consent to your child travelling in a leader's car, following the Safe Church Policy, for program related activities? *

Yes

Under Permission for each activity

Medical information

Does your child have any allergy? If so, does he/she use an EpiPen? *

Yes

If yes, please give us details.

Does your child have any dietary requirement? If so, please list them.

Does your child have any behaviour needs or conditions we need to be aware of or require special attention?

PLU56 Agreement

I am aware, by submitting this document regarding my child's participation in this program, that certain elements of the program could be physically and emotionally demanding. Furthermore, I understand that certain inherent risks and dangers may exist in the activities in which my child will be participating. I acknowledge that while the organisation and its leaders will make every reasonable effort to minimise exposure to known risks, all hazards and dangers associated with these activities cannot be foreseen or may be beyond the control of the organisation, its leaders and staff. In the event of any emergency where my nominated contact people are unavailable:

- I authorise the leaders to obtain medical advice and/or assistance which they deem necessary.
- I confirm that the information contained in this application is true and correct.

Privacy Policy - Pennant Hills Baptist Church (PLU56)

Pennant Hills Baptist Church (PHBC) is committed to the protection of personal information of the PHBC community. PHBC upholds members rights to privacy protection and adheres to the Privacy Act 1988 (Cth) and the Australian Privacy Principles which regulates the way Australian agencies collect, use, disclose, and store personal information.

- I/We hereby give consent to my/our personal information (name, address, email, phone contacts and date of birth) being collected, used, and disclosed for the purpose of emergency contacts(Elvanto).

This personal information will be recorded in the PHBC online database (Elvanto). Limited personnel have access to this online database.