Child Registration Form - Boys Brigade • Beenleigh Baptist

Child Registration Form - Boys Brigade

CS-10 February, 2023

Please complete Part A 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 each parent/carer has completed Part A. Press Blue Box + Add Another Person at the bottom of the form when Parts A & B have been completed for each child on the form. Hit the Submit button when last child's information has been entered.

Form Completion:

1. Parents/Carers complete the first section of the form (Part A Only)

2. Use the Parent/ Carer details for Name and Address, etc for completion of the first seciton of the form (Part A Only).

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

4. Repeat 1-3 for each of the Parents/Carers (Part A Only)

5. After pressing the Blue Button, +Add Extra Person(at the bottom of the page) for the last of the carers, you move to completing the details for the children.

6. Complete the details relevent for the child at the top of the form. (Part A)

7. Complete the remaining details for the child at the bottom of the form. (Part B)

8. If only one child completing this activity, hit the SUBMIT button at the bottom of the form.

9. Press the BLUE Button, +Add Extra Person (at the bottom of the page) for additional children.

10. Repeat 6-9 for additional children

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

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Part A

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: Church Policy / Protecting People/Forms)

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:

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

Other Information:

Relationship of adult completing Part A to the children in this form

If other relationship. please specify:

Are there any custody/guardian arrangements of which we should be made aware?

If there are such arrangements, please specify. You should also have a discussion with the group leader about these arrangements.

Transport

I hold a current Australian Drivers Licence and am available to drive children to activities when needed, in a vehicle which is roadworthy and carries third party insurance.

How many children can I transport in my vehicle?

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Consent:

I / We hereby consent to my child participating in the Boys' Brigade Program for this year, recognising that being part of a community involves mutual care and consideration and therefore agree that unacceptable behaviour may result in our / my child being sent home. I / We understand that every effort will be made to provide a safe environment for my 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. I understand that the information collected on this form will be used for the purpose of fulfilling The Boys' Brigade Australia's Objectives and duty of care for my child and will be treated securely and not be passed on for commercial purposes. I / We agree that the information provided by us at the time of signing this form is true and correct and not misleading in any form.

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.(Part A) Then complete the additional information at the bottom of the form.(Part B)

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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Part B

Additional CHILD DETAILS:

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, Epilepsy, Haemophilia, Heart/Blood problems, Migraines etc.)

Other medical needs: Eg Bedwetting, Dizziness, ADHD, 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:

Family Doctor's Name

Family Doctor's Phone Number

Do you have Private Health Insurance?

Private Medical Insurance Fund Details:

Private Medical Insurance Membership Number:

Emergency contact (EC):

EC - Relationship:

EC Phone

Additional Emergency Contact (EC2):

EC2- Relationship:

EC2 - Phone

School attended:

School Year Level:

Name of Church Sunday School attended:

Please rate your child's swimming ability:

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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: