Personal Information Form

Family Contact Details

Medical Information

Tip: Do you give permission for medical intervention (including ambulance services) in the case of an emergency and you are not able to be contacted immediately?

Tip: if applicable

Tip: Are there any conditions which King's Baptist Church Inc. should be aware of regarding the health and well being for your child eg. Asthma. allergies (food, drugs/medicine), convulsive seizures, diabetic?

Photos

Tip: Do you give permission for your child's photo to be taken and displayed on playgroup premises?

Tip: Do you give permission for your child's photo to be taken and used for promotion, either in printed material (on display or newsletter) or online (church website, facebook page)?