Holiday Kids Club 7-10 • Menai Anglican Church

300 out of 300 remaining tickets available

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Price

Quantity

#1 Holiday Kids Club 7-8 July

150 Remaining

Price
A$40.00

Quantity
#2 Holiday Kids Club 9-10 July

150 Remaining

Price
A$40.00

Quantity

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#1 Holiday Kids Club 7-8 July 0

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 and youth 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.

Child's Information

Child's First Name *

Child's Last Name *

Child's Gender

Best Parent Contact Email Address *

Best Parent Contact Mobile Number *

Date of Birth *

School Grade (K-5 only) *

School *

Do you attend a church other than Menai Anglican? If Yes, which one?

Parent/Guardian Details

Parent/Carer #1 Name *

Parent/Carer #1 Phone Number *

Parent/Carer #2 Name

Parent/Carer #2 Phone number

Emergency Information

Do you give permission for your child to be provide with medical treatment? *

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.

If in the event of an emergency, the leaders are unable to reach a parent, please provide another person you would like us to contact.

Emergency Contact Name *

Emergency Contact Number *

Emergency contact Relationship to Child

Legal Permissions

Are there any legal restrictions on who can pick up your child? *

If yes, please provide detail of the legal restrictions

Please list anyone else who has permission to pick up your child.

Photograph Permissions

Photos/Videos are sometimes taken during kid's Church activities. Occasionally, images or video footage taken during kid's church 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

Additional Needs Information

Does your child have additional needs? *

Yes

Please indicate the type of additional need?

ADHD

Autism Level 1

Autism Level 2

Autism Level 3

Sensory Processing Difficulties

Intellectual Disability

Learning Difficulties

Dyslexia

Dyspraxia

Global Developmental Delay

Anxiety

Trauma

Hearing Impairment

Visual Impairment

Physical Disability

Other

How does this additional need affect your child?

What additional support or adjustments should be provided for your child?

Would you be willing to provide additional information or reports to assist us in supporting your child?

Would you like a phone call from the access team to chat about supporting your child at the holiday kids club?

If yes, please email any additional information to the Children's Minister, Lauren Dewhurst lauren@menaianglican.org

Any questions or comments?

#2 Holiday Kids Club 9-10 July 0