Kids Club Registration Form 2024 • NCAChurch

NCAChurch Kids Club Enrolment Form

Please complete this form if you would like to send your child to NCA Kids Club on Fridays from 3.15pm-5pm.

Kids Club is open to all children in Years K to 5

Child's Information

First Name *

Last Name *

Date of Birth *

Gender *

School Grade *

Home Address *

Suburb *

Home Postcode *

Phone Number *

School Name *

Transport/Pick up

Would you like you child to be picked up from school and walked to Cammeray Anglican Church to attend Kids Club *

Additional Note for children being picked up from ANZAC Park PS.

In extreme weather conditions (eg. heavy rain, thunderstorm, hail) we will arrange for private vehicles to transport children safely from ANZAC Park PS to Cammeray Anglican Church. These vehicles will be driven by fully licenced designated leaders (no Provisional or Learner Drivers) and will comply fully with Safe Ministry guidelines.

I give permission for my child to be transported by private vehicle to Cammeray Anglican Church

Health and Safety

Does your child have any allergies or medical conditions? If yes, please provide full details below and supply the church office with treatment/action plan via email. If no, please enter n/a *

Tip: Please email office@ncachurch.com with response plans for anaphylaxis or asthma if applicable.

Is anyone legally restricted from seeing this child? *

If yes, please provide details below

Indemnity Form

Please read the indemnity form and select Yes if you agree to the conditions. *

I authorise the leader in charge of the Kids Club held at Cammeray Anglican Church, where it is impracticable to communicate with me, to arrange for my child to receive such medical treatment as the leader may deem necessary. I further authorise the use of an Ambulance if in the leaders judgment it is necessary. I accept responsibility for payment of all expenses associated with such treatment.

I appreciate that the leaders will take all reasonable care for the safety of my child. I also understand that the leaders cannot be held responsible for personal injury, loss or theft of property affecting my child.

My child agrees to follow the rules and directions given by the leaders. I agree to my child attending Kids Club on this understanding.

Photography

By giving permission for my child to be photogaphed, I understand that these photos will be used to document Kids Club, for advertising and for internal church communications.

I give permission for my child's photo to be taken *

Parent/Guardian Information

Primary Contact

This is the main contact in case of emergency as well as communication regarding your child.

Parent/Guardian: Full Name *

Parent/Guardian: Email *

Parent/Guardian: Phone Number *

Parent/Guardian: Home Address *

Secondary contact

This must be different to the Primary Contact. This secondary contact should be an adult relative or friend who is easily contactable in case of emergency when the primary contact is unable to contacted.

Secondary Contact: Full Name *

Secondary Contact: Phone Number *

Signature

Your signature below indicates your willingness to permit your child to participate fully in NCAChurch Kids Club Program for this year.

Signature (type name) *

Date *

Cost

The cost of Kids Club is $2 per child per week or $15 per child for the whole term.

Payment can be made in cash each week at Kids Club or by credit card for the whole term. Card payment can be made here.