Kids@OBC Form | Orange Baptist Church

Here at Orange Baptist Church the safety and wellbeing of the children and young people is our primary concern. The information provided below will allow us to create a safe environment for your child/ren.

By filling out this form you are granting permission for your child/ren to attend Kids@OBC.

All activities will be fully supervised and Child Safety Protocols will be adhered to.

Child/ren Information

Name

First

Last

Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Date of Birth

School Attending

Year

Dietry Requirements:

Is there anything your child can not eat and/or drink?

Yes
No

If yes, please indicate foods or beverages your child should not consume.

Medical Conditions:

Please list any medical conditions or allergies, and any medication or special care they require. If your child is anaphylactic to any substance please provide information regarding EpiPen and management plan.

Please click the ‘Add’ button to add any additional children that attend Kids@OBC

Parent/Guardian Information

Year displayed Relationship

Parent/Guardian 1

Name

First

Last

Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Relationship to Child/ren

Phone

Email

Parent/Guardian 2

Name

First

Last

Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Relationship to Child/ren

Phone

Email

In Case of Emergency

IN CASE OF EMERGENCY, the church will first contact Parent or guardian 1 (As Above) then if unavailable Parent or guardian 2 (As Above if provided) just in case neither of these are available for us to call then please supply another alternative contact.

Name

First

Last

Relationship to Child/ren

Phone

Medical Consent

I authorise the leader in charge of the above mentioned group/activities of Orange Baptist Church to arrange for my child/ren to receive any first aid, as may be deemed necessary. I further authorise the use of ambulance, medical surgical treatment or anaesthetic by a qualified medical practitioner if in his/her judgement it is necessary. I accept responsibility for payment of all expenses associated with such treatment. I agree that OBC Youth, Orange Baptist Church, its staff and leaders, shall not be held liable for any injury or damage arising from and/or connected with this event.

Media and Correspondence

The information collected here will be entered into our database. Orange Baptist Church adheres to the Privacy Act and will not disclose this information to third parties. We may use it to send you further information about Orange Baptist Church.

Orange Baptist Church may take photos and/or video footage at Orange Baptist Church activities and use it during our Sunday services or for promotional purposes.

I DO/DO NOT permit photos/videos taken of my child/ren to be displayed during the service on a Sunday.

I DO consent for both photos and video
I DO NOT consent for both photos and video

I DO/DO NOT permit photos/videos taken of my child/ren to be displayed in Church publications, e.g., website, newsletters, brochures, etc.

I DO consent for both photos and video
I DO NOT consent for both photos and video
I DO consent for photos only
I DO consent for video only

I DO/DO NOT wish to receive any correspondence from Orange Baptist Church

I DO
I DO NOT

By filling out this form you consent to this information being securely stored in the Orange Baptist Church database.

Database Consent

Signature of Parent/Guardian

Clear Signature

Date Form Completed