Registration Winter Kid's Club Registration & Payment Child/Children's full names and school grade * Child's address * Child's school: * Parent/Guardian details Parent/Guardian name: * Parent/Guardian email * Parent/Guardian phone * Relationship to child: * Emergency Contact Name (alternative to parent) * Emergency contact phone: * Allergies and medical details, such as medication required: (if none, please write 'none') * Are there any other details that would be helpful for us to know about so that we may provide the best care possible for your child? Payment Payment can be made on the day (cash only) or by bank transfer to St Andrews Anglican Sans Souci, BSB: 062250 Acc: 903703. Please leave as a reference 'WINTER' and your surname (or as much of that combination that you are able to) * I have paid (via bank transfer) I have not paid yet (will bring cash on the day) Permissions and Media In order to help us promote programs we run for children in our community, we ask for your permission to use group photographs which include your child. We will never use a photograph of any individual child; only group photos. Promotion avenues include printed media, school and church newsletters and website. * Yes I give permission for my child's photograph to be used for the above purposes. No I DO NOT give permission for my child's photograph to be used for the above purposes. My submission of this form indicates my willingness to permit my child to participate fully in the Winter Kid's Club. I authorise the leaders, in the event of an emergency, to obtain at my expense any medical, ambulance, rescue or other services considered necessary for the wellbeing of my child.