Zest For Life Holiday Kids Club • Macquarie Anglican

1 Day Ticket 0

Thanks for your interest in Zest For Life Holiday Club at Macquarie Anglican! Please fill out this form to register & pay for your child(ren).

Child's Details

Child's First Name *

Child's Last Name *

Street Address *

Suburb *

State *

Postcode *

Home Phone Number *

Gender *

Date of Birth *

School Grade (K-6 Only) *

Tip: Unfortunately we are unable to cater for preschoolers

School

Church attended (if any)

Zest Attendance Details

Days attending Zest For Life 2023 *

Wednesday (5th July)

Thursday (6th July)

Friday (7th July)

Do they have any friends coming to Zest? If yes, list names here

Tip: This will help us place them in a group with their friends

Medical & Care Needs

Does your child have any medical conditions/allergies we should know about? (if NO just leave blank).

Tip: i.e. chronic illness, allergies, dietary restrictions, medication we should know about?

Is there anyone who is legally restricted from seeing your child? (if NO just leave blank).

Is there anything else we should know about in caring for your child's needs?(if NO just leave blank).

Tip: i.e. behavioural concerns or restrictions, mental health needs (i.e. depression), etc.

Family and Emergency Contact Details

Parent/Caregiver 1

Name *

Relationship to child *

Preferred phone number *

Tip: Providing a mobile number is helpful as it allows us to send updates by SMS

Email address *

Parent/Caregiver 2

Name

Relationship to child

Preferred phone number

Email address

Emergency Contact (alternative to parent(s)/caregiver(s))

Name *

Relationship to child *

Preferred phone number *

Privacy Declaration

Macquarie Anglican Church respects your privacy. When you provide us with personal information by participating in church events/activities, visiting a website or otherwise, you agree to personal information about you and your children (under 18 years old) being handled as set out in the policy (available on our website). The personal information in this form will be made available to the Zest For Life leaders, and medical and emergency services if considered necessary.

Authorisations and Expectations

By accepting these conditions and submitting this form I permit my child to participate fully in activities associated with Zest For Life Holiday Club from the 5 July - 7 July 2022 at Macquarie Anglican.

In a medical emergency, I give my permission for a doctor chosen by a Macquarie Anglican leader to secure proper treatment for and/or order hospitalisation, injection, anaesthetic or surgery for my child as named. I understand that every effort will be made to contact me prior to instituting such procedures.

I also acknowledge and agree that any photographs or video of my child taken while participating in Zest For Life may be used by the church internally (i.e. during a church service, on church premises) to promote further childrens activities.

I understand that children attending Zest For Life must be signed in and out daily by a parent/authorised adult. I agree to notify the Zest For Life leaders of the names of any other authorised adults who can pick up my child.

I confirm that the information given in this form is correct, and will advise Zest For Life of any changes to this information.

Acceptance of conditions *

Yes that's fine!

No - I'd like to discuss this with the Zest For Life Coordinator

Your name *

2 Day Ticket 0

Thanks for your interest in Zest For Life Holiday Club at Macquarie Anglican! Please fill out this form to register & pay for your child(ren).

Child's Details

Child's First Name *

Child's Last Name *

Street Address *

Suburb *

State *

Postcode *

Home Phone Number *

Gender *

Date of Birth *

School Grade (K-6 Only) *

Tip: Unfortunately we are unable to cater for preschoolers

School

Church attended (if any)

Zest Attendance Details

Days attending Zest For Life 2023 *

Wednesday (5th July)

Thursday (6th July)

Friday (7th July)

Do they have any friends coming to Zest? If yes, list names here

Tip: This will help us place them in a group with their friends

Medical & Care Needs

Does your child have any medical conditions/allergies we should know about? (if NO just leave blank).

Tip: i.e. chronic illness, allergies, dietary restrictions, medication we should know about?

Is there anyone who is legally restricted from seeing your child? (if NO just leave blank).

Is there anything else we should know about in caring for your child's needs?(if NO just leave blank).

Tip: i.e. behavioural concerns or restrictions, mental health needs (i.e. depression), etc.

Family and Emergency Contact Details

Parent/Caregiver 1

Name *

Relationship to child *

Preferred phone number *

Tip: Providing a mobile number is helpful as it allows us to send updates by SMS

Email address *

Parent/Caregiver 2

Name

Relationship to child

Preferred phone number

Email address

Emergency Contact (alternative to parent(s)/caregiver(s))

Name *

Relationship to child *

Preferred phone number *

Privacy Declaration

Macquarie Anglican Church respects your privacy. When you provide us with personal information by participating in church events/activities, visiting a website or otherwise, you agree to personal information about you and your children (under 18 years old) being handled as set out in the policy (available on our website). The personal information in this form will be made available to the Zest For Life leaders, and medical and emergency services if considered necessary.

Authorisations and Expectations

By accepting these conditions and submitting this form I permit my child to participate fully in activities associated with Zest For Life Holiday Club from the 5 July - 7 July 2022 at Macquarie Anglican.

In a medical emergency, I give my permission for a doctor chosen by a Macquarie Anglican leader to secure proper treatment for and/or order hospitalisation, injection, anaesthetic or surgery for my child as named. I understand that every effort will be made to contact me prior to instituting such procedures.

I also acknowledge and agree that any photographs or video of my child taken while participating in Zest For Life may be used by the church internally (i.e. during a church service, on church premises) to promote further childrens activities.

I understand that children attending Zest For Life must be signed in and out daily by a parent/authorised adult. I agree to notify the Zest For Life leaders of the names of any other authorised adults who can pick up my child.

I confirm that the information given in this form is correct, and will advise Zest For Life of any changes to this information.

Acceptance of conditions *

Yes that's fine!

No - I'd like to discuss this with the Zest For Life Coordinator

Your name *

3 Day Ticket 0

Thanks for your interest in Zest For Life Holiday Club at Macquarie Anglican! Please fill out this form to register & pay for your child(ren).

Child's Details

Child's First Name *

Child's Last Name *

Street Address *

Suburb *

State *

Postcode *

Home Phone Number *

Gender *

Date of Birth *

School Grade (K-6 Only) *

Tip: Unfortunately we are unable to cater for preschoolers

School

Church attended (if any)

Zest Attendance Details

Days attending Zest For Life 2023 *

Wednesday (5th July)

Thursday (6th July)

Friday (7th July)

Do they have any friends coming to Zest? If yes, list names here

Tip: This will help us place them in a group with their friends

Medical & Care Needs

Does your child have any medical conditions/allergies we should know about? (if NO just leave blank).

Tip: i.e. chronic illness, allergies, dietary restrictions, medication we should know about?

Is there anyone who is legally restricted from seeing your child? (if NO just leave blank).

Is there anything else we should know about in caring for your child's needs?(if NO just leave blank).

Tip: i.e. behavioural concerns or restrictions, mental health needs (i.e. depression), etc.

Family and Emergency Contact Details

Parent/Caregiver 1

Name *

Relationship to child *

Preferred phone number *

Tip: Providing a mobile number is helpful as it allows us to send updates by SMS

Email address *

Parent/Caregiver 2

Name

Relationship to child

Preferred phone number

Email address

Emergency Contact (alternative to parent(s)/caregiver(s))

Name *

Relationship to child *

Preferred phone number *

Privacy Declaration

Macquarie Anglican Church respects your privacy. When you provide us with personal information by participating in church events/activities, visiting a website or otherwise, you agree to personal information about you and your children (under 18 years old) being handled as set out in the policy (available on our website). The personal information in this form will be made available to the Zest For Life leaders, and medical and emergency services if considered necessary.

Authorisations and Expectations

By accepting these conditions and submitting this form I permit my child to participate fully in activities associated with Zest For Life Holiday Club from the 5 July - 7 July 2022 at Macquarie Anglican.

In a medical emergency, I give my permission for a doctor chosen by a Macquarie Anglican leader to secure proper treatment for and/or order hospitalisation, injection, anaesthetic or surgery for my child as named. I understand that every effort will be made to contact me prior to instituting such procedures.

I also acknowledge and agree that any photographs or video of my child taken while participating in Zest For Life may be used by the church internally (i.e. during a church service, on church premises) to promote further childrens activities.

I understand that children attending Zest For Life must be signed in and out daily by a parent/authorised adult. I agree to notify the Zest For Life leaders of the names of any other authorised adults who can pick up my child.

I confirm that the information given in this form is correct, and will advise Zest For Life of any changes to this information.

Acceptance of conditions *

Yes that's fine!

No - I'd like to discuss this with the Zest For Life Coordinator

Your name *