2025 Playspace Registration Form QR

We are excited that you are a part of Menai Anglican Church's ministry!

In accordance with the Privacy Act, 1988, we inform you that all personal information collected will be used for the purpose of contacting carers in the event of an emergency, providing medical care for your child and for informing you of children's activities that are authorised or approved by Menai Anglican Church. It will not be distributed to any other organisation.

Thank you for providing this important information.

You can view our Privacy Policy here.

Group Attending

I give permission for my child to participate fully in activities run by Menai Anglican Church. I understand that these activities will be run on the premises of the church.

0 to 5 years Groups Attending:

Little Church Sun 10am

PlaySpace Mon 10am

PlaySpace Tues 10am

PlaySpace Thurs 10am

How did you hear about PlaySpace?

Child's Information

First Name *

Last Name *

Date of Birth *

Best Parent Contact Mobile Number

Address

City

State

Post Code

Parent/Guardian Details

Parent/Carer #1 First and Last Name *

Parent/Carer #1 Phone Number *

Parent/Carer #1 Email *

Parent/Carer #2 First and Last Name

Parent/Carer #2 Phone number

Parent/Carer #2 Email

Emergency Information

Does your child have any medical conditions? (please provide details)

Does your child take any medication? (please provide details)

Does your child have any allergies? (please provide details)

If your child has an Allergy, Asthma or Anaphylaxis Action Plan please provide the church with a copy.

Emergency Contact Name (other than parent) *

Emergency Contact Number *

Photograph Permissions

Photos/Videos are sometimes taken during playspace activities. Occasionally, images or video footage taken during playspace activities might be shared on social media, used on the Menai Anglican Church Website or Facebook Page or used for advertising in the community (no names included). Please indicate below if you give permission for photos/videos of your child to be used.

Permission to take and use photos/video? *

Yes

Group Attending

Child's Information

Parent/Guardian Details

Emergency Information

Photograph Permissions

Additional Needs Information