Child Registration Form - Master • Beenleigh Baptist

Please complete the top section of the form for each of the people relating to the submission. This will generally be for the Parents or Carers and then the child/ ren. Press Blue Box + Add Another Person at the bottom of the form when complete for each Parent / Carer BEFORE adding details about the child/ren.

Form Completion:

1. Parents/Carers complete the first section of the form.

2. Use the Parent/ Carer details for Name and Address, etc for completion of the first seciton of the form.

3. Press the BLUE Button, +Add Extra Person (at the bottom of the page) after completing the first section.

4. Repeat 1-3 for each of the Parents/Carers

5. Complete the details relevent for the child at the top of the form.

6. Complete the remaining details for the child at the bottom of the form.

7. Press the BLUE Button, +Add Extra Person (at the bottom of the page) after ccompleting the details about the child.

8. Repeat 5-7 for additional children

9. Press the Grey SUBMIT Button at the bottom of the form when you have completed the form.

Area of Ministry:

(Please do not use this form if your are registering your child or young person with Boys Brigade or Girls Brigade. These ministries have their own registration forms.)

Area of Ministry:

If Other, please give details:

Contact Details:

The following contact details are for: *

First Name *

Last Name *

Phone Number

Email Address

Home Address

Home Address Line 2

Home City

Home Postcode

Child Safety Code of Conduct:

I have read and agree with Beenleigh Baptist Church's Child Safety Code of Conduct. (Available from Church Website & Elvanto) *

Child Conduct:

I recognise that being a part of our community involves mutual care and consideration and therefore agree that unacceptable behaviour may result in my/our child/ren being returned to parents or carers. *

Photography:

Do you give permission for my/our child/ren to be photographed and the photos used by Beenleigh and District Baptist Church? *

Social Media:

Social Media: I give permission for my/our child to be photographed or videographed and the photos/videos used on social media by Beenleigh Baptist Church. *

Consent:

The information I have provided in this form is accurate and I consent for my child/ ren to participate in the nominated activity/ activities: *

When this section is completed, press the Blue Box + Add Another Person at the bottom of the form.

Once Parent and Carers have been added, please press the Blue + Add Another Person box. Complete the Name and contact details now for each Child in the top section of the form. Then complete the additional information at the bottom of the form.

Press the Blue Buttom (+ Add Extra Person) NOW if you finished entering the details of the Parent/ Carer. This blue button is at the bottom of the page. Scroll down or slide up NOW.

Continue if you are adding additional details about a child.

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Additional details for your CHILD or Young Person:

Preferred Name

Date of Birth

Gender

Allergy / Special Diet

Allergy (Detail)

Asthma:

Has hospitalisation for Asthma occurred in the past 12 months?

Is there an Asthma Management Plan? (If so, please email to the church office so it can be attached to this submission.)

Anaphylaxis:

Has hospitalisation for Anaphylaxis occurred in the past 12 months?

Is there an Anaphylaxis Management Plan? (If so, please email to the church office so it can be attached to this submission.)

Does your child carry their own Epi-Pen?

List other medical information. (Eg. Diabetes, Migraines etc.)

Is there a medical health plan? (If so, please email to the church office to attach to this submission.)

Medications currently being taken (Please list):

Date of last Tetanus Injection:

Medicare Number:

Emergency Contacts:

Emergency contact (EC):

EC - Relationship:

EC Phone

Additional Emergency Contact (EC2):

EC2- Relationship:

EC2 - Phone

I/We understand that every effort will be made to provide a safe environment for my/our child to participate in. However, in the event of an emergency I/we authorise the leaders to obtain at my/our expense, any medical, ambulance or similar services that are considered necessary by the leaders.

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Pick Up Details: In addition to the Parents / Carers and Emergency Contacts who else has authority to pick up the child/ren?

PickUp 1 Name:

Pickup 1 Relationship to child:

Pickup 1 Phone Number:

Pickup 2 Name:

Pickup 2 Relationship to child:

Pickup 2 Phone: