WBCKids - 2024 Registration Form • Werribee Baptist Church

WBCKids Child Registration Form 2024

CHILD DETAILS

First/Preferred Name *

Surname *

Gender

Date of Birth *

School Grade *

PARENT/GUARDIAN DETAILS

Primary Guardian Details

Full Name *

Mobile *

Email Address *

Other Guardian Details

Full Name

Mobile

We may use this information to communicate with you throughout the year.

Home Address

Home City

Home Postcode *

We encourage parents to visit Kids Central and be a part of our WBCKids service as a Parent Leader throughout the year. A leader will make contact with parents in the weeks prior to schedule your visit. Please select your preferred frequency.

Once a month

Once a term

Once a semester

ABOUT YOUR CHILD

Medical Information

Asthma (please provide management plan)

Anaphylaxis (please provide management plan)

Food Allergy (please specify)

Other Allergy (please specify)

Medical Condition (please specify)

If your child has an official Medical Condition Action Plan. Please email a copy to the WBCKids Team at kids@werribeebaptist.org.au

Family Information

Current Custody or Intervention Order in place

Other relevant Family Situation (please specify)

Is your child of Aboriginal or Torres Strait Islander origin? *

Yes

Please tell us anything you feel we should know about your child; including ... additional needs, hobbies/likes/dislikes (as conversation starters) cultural, learning or behavioural needs, pertinent family issues, other medical issues, fears, or anything else that will best help us serve your children.

IMPORTANT TO NOTE

By completing this form you acknowledge that:
You have authority to provide this true information and agree to update Werribee Baptist Church if any information changes.
If urgent medical attention is required, emergency services may be notified as well as the contacts on this form. If the listed contacts can not be reached, your child will receive medical attention as deemed necessary by the leader/s in charge of the program/activity.

Privacy Statement
In accordance with the Privacy Policy of The Baptist Union of Victoria any information provided will be used only for the ministry of this church and activities related to this church. The information will not be released to any organisation outside of this church.

Photograph Disclaimer
At times we take photos and/or video of the children in WBCKids which may be used for church promotional purposes during services or online. Please advise us in the the below if you do not give permission for this usage.

ACKNOWLEDGEMENT

Please click the Acknowledgement bubble *

I acknowledge I have read and understood the above Important To Note section.

Photograph Permission *

Approve

Decline

Any other notes you would like us to know

ELECTRONIC SIGNATURE

I (Enter name of Parent/Gardian) *

have completed the above form with the understanding that this child will be registered as part of the 2024 WBCKids program of Werribee Baptist Church.