Kids Church Permission Form - 2026 • Central Villages Anglican Church, Lawson

Kids Church Permission Form 2026

To be completed for all young people under 18 years attending Kids Church in 2026.

Effective from January 2026 to December 2026 for Central Villages Anglican Kids Church Program.

Child Details

First Name *

Last Name *

Date of Birth *

Gender *

Place of Learning

Grade/Learning Stage *

Medicare Number

Position on card

Medicare expiry date

Ambulance Cover (Y/N)

Please be aware that Medicare information is not mandatory but helpful to have in case of emergencies.

We will keep these details on file so that we do not have to ask for them prior to each event, unless you request otherwise. Please advise the Central Villages Anglican Church Kids/Youth leaders as soon as practical of any changes to this information.

Parent/Caregiver 1 Details

First Name *

Last Name *

Mobile Number *

Other Number

Email Address *

Home Address *

Parent/Caregiver 2 Details

First Name

Last name

Mobile Number

Other Number

Home Address (if different)

Alternative Emergency Contact Details

First Name *

Last name *

Mobile Number *

Other Number

Privacy Declaration

Central Villages Anglican Church is exempt from the requirements of the Privacy Act 1988 as it is a “small business”. However, we seek to deal carefully with the personal information we collect and to do so in a manner consistent with your reasonable expectations.

The personal information in this form will be made available to –

(a) the leaders involved in the running of the activities in which your child participates, and

(b) medical and emergency services if considered necessary.

Authorisations & Expectations

I give permission for photos/videos of my child taken at Central Villages Anglican Church Kids/Youth events to be displayed publicly (online and in print) unless I advise the Central Villages Anglican Church Kids Church leaders otherwise.

I, the parent or caregiver, agree to the above.

I agree

I give permission for my child to attend all scheduled Central Villages Anglican Church Kids Church activities, unless I advise the Central Villages Anglican Church Kids Church Leaders (the Leaders) otherwise.
I authorise the Leaders, in the event of an emergency, to obtain at my expense any medical, ambulance, rescue or other services that are considered necessary for my child.
I acknowledge that being part of a community involves mutual care and consideration, and therefore agree that unacceptable behaviour may result in a discussion between me (the parent/carer) and the Leaders to determine the best course of action.
I will provide the Leaders with any information relevant to the wellbeing of my child prior to him or her attending a Central Villages Anglican Church Kids Church activity.
I confirm that the information given in this form is true and correct, and will advise Central Villages Anglican Church of any changes to this information.

I, the parent or caregiver, agree to the above. *

I agree