Personal Information

Please complete fields as appropriate for all adults and children who will be attending Emmanuel Playgroup for 2021.

Medical Information

Please complete fields as appropriate so that we can best care for you /your child/ren while in our care.

Tip: Please provide clear details to assist leaders and first-aiders in the event of an emergency and to provide best possible care and consideration to your needs in programming.

Emergency Contacts

Please list Next of Kin and at least one other person that we can contact should something happen to you while at playgroup or other related event.

Church Attendance

Education and Work details

Please complete fields as appropriate for adults and children. 

Privacy Statement, Consent, Indemnity, Photography and Media Release

Protecting your privacy is import to us. The information we seek allows us to manage risk, provide reasonable care and allow for your involvement in our program. We only ask for information that is necessary for managing the programs you are participating in and are careful to keep your information confidential, and provide it only to those who require access to it for your care. If you have any questions about your information or how it is stored please contact the church office. 

Tip: Please read and check all 6 fields.

At times the activities of Playgroup will be photographed, audio and or visually recorded.  Do you give permission for Emmanuel Playgroup and Emmanuel Uniting Church to use photos or digital media taken by us which may identify yourself/ your child/ren?

Note: Names identifying children will never be posted with images.

Please read all 4 options here and tick those that you agree to.

Tip: Please type your name here in acknowledgment of form completion