Abundant Life Centre Busselton
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KIDS & YOUTH
VISION
We see a generation of kids, youth and young adults rising up into all that God has destined for them.
We see a generation of young authentic Christ followers, equipped to change the world through radical love and obedience to Jesus.
KID'S MINISTRY REGISTRATION FORM
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Indicates required field
Parent / Carer Name:
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Parent / Carer Phone Number
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Parent / Carer Email
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Today's Date (dd mm yy)
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Please complete details below for each child you are registering. Please include information about special needs (hearing, speech, ADD), allergies (e.g. nuts, dairy), and medications (e.g. Ventolin). Please include any other relevant information you feel we may need to know.
1st Child - Name
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1st Child - School Year
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1st Child - Date of Birth
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1st Child - Special Needs / Allergies / Medications
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2nd Child - Name
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2nd Child - School Year
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2nd Child - Date of Birth
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2nd Child - Special Needs / Allergies / Medications
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3rd Child - Name
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3rd Child - School Year
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3rd Child - Date of Birth
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3rd Child - Special Needs / Allergies / Medications
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4th Child - Name
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4th Child - School Year
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4th Child - Date of Birth
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4th Child - Special Needs / Allergies / Medications
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Do you give permission for us to include your children in our photo's and videos? (Promotional use for ALC only)
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< please select >
Yes
No
Do you give permission for an ALC KIDS Team Member to call an ambulance for your child in an emergency?
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< please select >
Yes
No
Please include any additional information here that will assist us to best provide for your child.
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Thank you for taking the time to provide us with these details. They will assist us to best provide for your child. God bless you.
From the
ALC KIDS Team
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Submit
PARENT / CARER PERMISSION
Parent / Carer permission for all ALC Youth activities.
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Indicates required field
Child's First Name
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Child's Last Name
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Child's Mobile Number
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Child's Email Address
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Child's Street Address
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Child's allergies, dietary requirements or medical conditions for leaders to be aware of
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Parent / Carer First Name
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Parent / Carer Email Address
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Sign Out Preferences
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I will sign out my child
My child can sign themselves out
Another parent can sign out my child
Child's Date of Birth
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School
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School Grade
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Child's Swimming Proficiency
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- Select -
None
Limited
Proficient
Advanced
Parent / Carer Mobile Number
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Parent / Carer Home Phone
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Other Information
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PARENT / CARER DECLARATION
I consent to my child being a part of the ALC Youth program. I will encourage my child to attend and participate regularly and to cooperate with the leaders and other children.
In any emergency, should I not be contactable, I authorise the leaders in charge of the ALC Youth Group to arrange for my child to receive such first aid, medical or surgical treatment as the leader may deem necessary at any time during the activities. I further authorise the use of Ambulance and/or anaesthetic by a qualified medical practitioner if in his/her judgement it is necessary. I accept responsibility for payment of all expenses associated with such treatment.
I agree to indemnify and hold no liability to Abundant Life Centre Busselton Inc and any individual staff or voluntary leaders against all claims arising out of any injury to my child and the relevant activity being undertaken, unless such injuries result from a failure in the duty of care of Abundant Life Centre Busselton, individual staff or volunteer leader.
I give permission for my child to be photographed and/or recorded during the course of the activity for the purposes of creating promotional material for the Church and/or its ministries.
Please Indicate your consent below
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< please select >
Yes
No
EXTERNAL ACTIVITIES
I give permission for my child to participate in activities based outside of the Abundant Life Centre Busselton building and to be transported in private cars arranged by the leaders of the ALC Youth Group.
(Please note that the leaders of the ALC Youth Group will always seek to communicate in advance the details of any external activities including transport arrangements and only full licence drivers will be used.)
Please Indicate your consent below
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< please select >
Yes
No
Other comments or things to let us know
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Submit