Lifegate Kids Holiday club 2026 • Lifegate Church

Lifegate Kids Holiday Club

Welcome to Lifegate Holiday Kids Club!

This registration form allows children to attend the Holiday Kids Club on Friday July 17th at Lifegate Church, 35 Cahors Road, Padstow from 8:30 am to 3 pm.

Please bring recess, lunch, and a water bottle. Cut fruit and small food prizes will be provided throughout the day.

We are excited to have you. See you then!

Parent/Guardian Information

1. Full Name

Email Address

Home Address

Phone Number

Child Details

First Name

Last Name

Date of Birth

Age

School Grade

Please list any allergies your child has. Snacks and treats prizes will be provided. Children are to provide their own lunch and drink bottled to ensure it is safe for them.

Does your child have any Additional Needs?

Please Specify

Does your child have any Medical Conditions? Eg. Asthma

Please provide medical information relevant to the care of your child, that may require attention from our leaders.

Does your child require any medicine?

Yes

Please provide us with the medication required, dosage and when it is to be taken.

Are there any friends your child has registered with?

Emergency Contact

2. Full Name

Contact Number:

Emergency Contact's relationship to child

Actvities

Each child will be able to choose two workshops to participate in during the day. Please number 1-5 your preferred workshop using 1 as your highest preference and 5 as your least preferred option.

One

Two

Three

Four

Five

Permissions

I give permission for:

My child walking to this activity at Playford Park, Padstow under the supervision of the Lifegate Kids Leaders.

My child attending the activities at Playford Park

The use of any photographs or video footage that may be taken of my child to be used or shown as the Lifegate Church see fit.

Information about my child being collected as required for accident/incident forms

I understand that if urgent medical attention is needed, that every effort will be made to contact the persons listed on this form. In the event that I cannot be contacted in an emergency, I give my permission for my child to receive such medical treatment, as the leader may deem necessary. I will be responsible for any and all related expenses.

I understand that all reasonable safety precautions will be taken at all times by the above mentioned group and that the leaders and those connected with the group cannot be held responsible for personal injury incurred by the child on this form.

I understand that my child will receive teaching from The Bible about Jesus and the life He offers

Is there anyone who is not allowed to collect your child?

please list here

Payment

$15 per child. Payment to be made before Holiday Kids Club July 17th.

Account Name: Lifegate Church Incorporated
BSB: 082-356
Account Number: 160185956
Reference: (child’s name)+ Kids Holiday Club

We are excited to have your Child apart of our Hoilday club! If you have any questions feel free to reach out.

Kathryn Reed: Kids Pastor

E: kathryn.reed@lifegate.org.au

P: 0421 784 476

Cherrie Parrott: Hoilday club coordinator

E: cherriefroggy@gmail.com

P: 0432 315 382

Felicity Chamberlain: Hoilday club coordinator

E: felicity.chamberlain24@gmail.com
P:0452 644 636