Youth & Children's Enrolment Form • Wahroonga Anglican

Registration for Youth Church and Children's Activities at Wahroonga Anglican Churches

Please complete this form for each child you are registering

This information will be kept confidential and will only be used to assist the Youth and Children's leaders to ensure your childs well being. If you have any questions about how this information is used or kept, or our programs, please feel free to contact Tamar Pollard at tamar.pollard@wahroonga.church

Child's Details

First Name *

Date of Birth *

Address

Address Line 2

Suburb

Mailing Post Code

Last Name *

School Grade *

School Attended

Phone Number

Mobile Number

Parent/Guardian - Mother

Mother Name

Mother Email *

Mother Phone *

Parent/Guardian - Father

Father Name

Father Email

Father Phone

Other information required:

Does your child have a special needs you'd like us to know about (physical, mental, learning, emotional, or English as a 2nd language) or significant behavioural problems? *

Is there anything else that we should know about your child? *

Is anyone legally restricted from seeing this child? *

If yes, please provide details:

Is this child on a special diet we should know about? *

Please describe in full any allergies (food, drug, environmental) your child has, and medication, if required:

Please detail any operations or serious illnesses below:

If your child is restricted from any activity, please note the restriction and specify the condition involved here:

Other information or Comments

For Vine (years 6-12) only:

I give permission for my child in year 7-12 to be a part of the church What's App Group for communications amongst their small group. Each small group will have at least 2 trained leaders who will moderate the group. No one to one communication between leaders and children is permitted. If you give permission please provide your Childs mobile phone number below (please check with them first)

I give permission

I don't give permission

Child's Mobile Phone Number

Permissions

I give permission for photos and videos of my children to be used for internal church events like prayer nights, recap videos and other productions to show in church. *

Photos allowed

No photos to be used

Tip: This will be used only within the Church family, and will never be shared externally

I permit my child to participate fully in the activities associated with Wahroonga Anglican Youth and Children's programs. Most of these activities will take place on the grounds of 2 Water St or Pearces Corner Wahroonga, or occasionally the grounds of Prouille School or Wahroonga Park. *

I agree

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 confirm that the information given in this form is true and correct, and will advise of any changes to this information.