Lifegate, 222 Hoxton Park Road, Prestons
Wednesday 3, 2018
8 am to 5 pm
Child's names and details
If your child has a Medical Condition that requires medication, please complete the following:
Parent/Guardian's name and Contact details:
If you have multiple children to register, please only complete the Parents & Emergency Contact details once.
In case of emergency and the Parent/Guardian is unable to be contacted, please provide an emergency contact.
Please read the following points and mark your response for each section.
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.
Information and Media
I consent to the following:
Note: on the morning when kids sign in, parents will be given a pick-up pass. The pass is required to collect your child at the end of the day.
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 of this form.
I understand that the Lifegate Community Church cannot be held responsible for loss or damage of any items taken, by the child of this form, to this activity.
By submitting this form, you are agreeing to the details on this form.
Lifegate Church is a Christian Church where we teach on finding Freedom and Purpose through Jesus, and Holiday Club will include teaching times where we will introduce them to Jesus.
Once your registration form has been received we will send you confirmation of the registration. This confirmation will include payment details.