Children's Church Form 2026 • Warrandyte Community Church

Child's Details

First Name *

Date of Birth *

Last Name *

Family's Details

Parent/Guardian Name *

Phone Number *

Email Address *

Home Address *

I consent for my child to participate in Warrandyte Community Church Children’s programs.

I will encourage my child to cooperate with the leaders and other children.

If I am not contactable, I authorise the leader in charge to arrange for my child to receive such first aid, medical or surgical treatment as the leaders may deem necessary at any time during the programs. I further authorise the use of Ambulance and /or aesthetic by a qualified medical practitioner where in his/her judgment it is necessary. I accept responsibility for payment of all expenses associated with such treatment.

I agree to indemnify and hold harmless the Warrandyte Community Church against all claims, demands, suits and liability of whatever nature and howsoever arising out of the injury to the child and the relevant activity being undertaken.

Parent/Guardian Name *

Parent/Guardian Authorised *

Please check box

Date *

Medical Record Information

Child's Name *

Medicare Number *

Allergies

Current Medications

Other Medical Information or Behavioural Concerns

Parent/Guardian Name *

Parent/Guardian Authorised *

Please check box

Date *

Photo & Video Permission Form

I being the parent/guardian for the said child give my consent for my child to be captured in both photography and video.

If you do not give permission, please do not mark the box.

Note: Photos or Video may be used for promotional purposes in a range of media, including hard copy and electronic formats.

Child's Name

Parent/Guardian Name

Date *

Parent/Guardian Authorised

Please check box

Privacy Statement

We only collect information where it is necessary to do so to provide a service to you, or where we are required by law to do so. Access to your personal information is restricted to staff and support staff who require information to provide a service to you. Your details are not available to everyone. We will not pass on any of your personal details to any other organisation or third party. For a copy of our Privacy Policy and how your information is handled please visit our website wcc.org.au.