Playgroup Term 2

Child's Information

First Name *

Last Name *

Sex *

Male

Female

Date of Birth *

Age *

Does your child have any allergies?

Does your child have any Medical Conditions?

Do you have any other children attending

Yes

Second Child

First Name

Last Name

Sex

Date of Birth

Age

Does you child have any allergies?

Does your child have any other medical conditions?

Do you have a third child attending?

Yes

Third Child

First Name

Last Name

Sex

Date of Birth

Age

Does you child have any allergies?

Does your child have any other medical conditions?

Do you have a fourth child attending?

Yes

Fourth Child

First Name

Last Name

Sex

Date Of Birth

Age

Does your child have any allergies?

Does your child have any other medical conditions?

Parent/Guardian Details

Parent/Guardian's Name *

Partner's Name *

Email Address *

Postal Address *

Child/ren's Address (List if different from above address)

Mobile Number *

Home Number

Emergency Contact Details

Name *

Relationship to child *

Mobile Number *

Home Number

First preference of day to attend playgroup

Tuesday

Wednesday

Thursday

Second preference of day to attend playgroup

Tuesday

Wednesday

Thursday

Please tell us why you chose our playgroup, and how you heard about us

Privacy

The primary purpose of collecting this information is to enable to the Suburban Playgroup to adequately care for your child. All information regarding children is sensitive information within the terms of the national privacy principles under the Privacy Act. Your child's information will be entered into our church database for administrative purposes. Only staff have access to this database and your child's information will remain confidential and secure. You may receive emails which pertain to the Playgroup program.

If you would like more information you are welcome to access the Church Privacy Policy via the website.

Indemnity Statement

I authorise the leader in charge of the Suburban Playgroup, where it is impracticable to communicate with me, to consent for my child to receive such medical or surgical treatment as may be deemed necessary. *

Yes

I understand that my child/ren must be accompanied by an authorised, supervising adult who is responsible for my child/ren and their safety whilst they are attending Suburban Playgroup. *

Yes

"I agree to indemnify and hold harmless the Suburban Playgroup and the Suburban Church against all claims, demands, suits and liability of whatever arises out of any injury to my child or myself whilst at playgroup." *

Yes

Child Safety

At Suburban Kids we value the physical, emotional and spiritual safety of all kids, all the time. Therefore, we will always seek to be a place where kids feel safe. In order to practically make this happen we have a very thorough child protection policy and a code of conduct which all of our volunteers read and agree to abide by, in addition to obtaining a working with children check. If you would like to read our policy, procedures and code of conduct in relation to child safety go to https://www.suburbanchurch.org/whats-going-on/kids

Privacy Policy

All information provided in this form will be treated with care and respect, and will not be disclosed to parties outside of Suburban Church. For information about our privacy policy, please see: Suburban Church Privacy Policy. By clicking 'Submit', you agree to its terms.

Child's Information

First Name *

Last Name *

Sex *

Male

Female

Date of Birth *

Age *

Does your child have any allergies?

Does your child have any Medical Conditions?

Do you have any other children attending

Yes

Second Child

First Name

Last Name

Sex

Date of Birth

Age

Does you child have any allergies?

Does your child have any other medical conditions?

Do you have a third child attending?

Yes

Third Child

First Name

Last Name

Sex

Date of Birth

Age

Does you child have any allergies?

Does your child have any other medical conditions?

Do you have a fourth child attending?

Yes

Fourth Child

First Name

Last Name

Sex

Date Of Birth

Age

Does your child have any allergies?

Does your child have any other medical conditions?

Parent/Guardian Details

Parent/Guardian's Name *

Partner's Name *

Email Address *

Postal Address *

Child/ren's Address (List if different from above address)

Mobile Number *

Home Number

Emergency Contact Details

Name *

Relationship to child *

Mobile Number *

Home Number

First preference of day to attend playgroup

Tuesday

Wednesday

Thursday

Second preference of day to attend playgroup

Tuesday

Wednesday

Thursday

Please tell us why you chose our playgroup, and how you heard about us

Privacy

If you would like more information you are welcome to access the Church Privacy Policy via the website.

Indemnity Statement

Yes

I understand that my child/ren must be accompanied by an authorised, supervising adult who is responsible for my child/ren and their safety whilst they are attending Suburban Playgroup. *

Yes

Child Safety

Privacy Policy

Child's Information

First Name *

Last Name *

Sex *

Male

Female

Date of Birth *

Age *

Does your child have any allergies?

Does your child have any Medical Conditions?

Do you have any other children attending

Yes

Second Child

First Name

Last Name

Sex

Date of Birth

Age

Does you child have any allergies?

Does your child have any other medical conditions?

Do you have a third child attending?

Yes

Third Child

First Name

Last Name

Sex

Date of Birth

Age

Does you child have any allergies?

Does your child have any other medical conditions?

Do you have a fourth child attending?

Yes

Fourth Child

First Name

Last Name

Sex

Date Of Birth

Age

Does your child have any allergies?

Does your child have any other medical conditions?

Parent/Guardian Details

Parent/Guardian's Name *

Partner's Name *

Email Address *

Postal Address *

Child/ren's Address (List if different from above address)

Mobile Number *

Home Number

Emergency Contact Details

Name *

Relationship to child *

Mobile Number *

Home Number

First preference of day to attend playgroup

Tuesday

Wednesday

Thursday

Second preference of day to attend playgroup

Tuesday

Wednesday

Thursday

Please tell us why you chose our playgroup, and how you heard about us

Privacy

If you would like more information you are welcome to access the Church Privacy Policy via the website.

Indemnity Statement

Yes

I understand that my child/ren must be accompanied by an authorised, supervising adult who is responsible for my child/ren and their safety whilst they are attending Suburban Playgroup. *

Yes

Playgroup - Tuesday (1 Ticket per family) 0

Child's Information

Second Child

Third Child

Fourth Child

Parent/Guardian Details

Emergency Contact Details

Privacy

Indemnity Statement

Consent

Child Safety

Privacy Policy

Playgroup - Wednesday (1 Ticket per family) 0

Child's Information

Second Child

Third Child

Fourth Child

Parent/Guardian Details

Emergency Contact Details

Privacy

Indemnity Statement

Consent

Child Safety

Privacy Policy

Playgroup - Thursday (1 Ticket per family) 0

Child's Information

Second Child

Third Child

Fourth Child

Parent/Guardian Details

Emergency Contact Details

Privacy

Indemnity Statement

Consent

Child Safety

Privacy Policy