Parent / Caregiver 1

This information will automatically fill for additional children below.

Parent / Caregiver 2

This information will automatically fill for additional children below.

Emergency Contact

This information will automatically fill for additional children below.

Privacy Declaration

Burnie Anglican Church is exempt from the Requirements of the Privacy Act 1988 (Cth) as it is a "small business". However, we take the handling of personal details seriously. We seek to deal carefully with the personal information we collect and to do so in a manner consistent with your reasonable expectations.
The personal information in this form will be made available to:

  1. the Team Leaders involved in the running of the activities in which my child participates, and
  2. medical and emergency services if considered necessary.

Images and Video (General)

I agree that I will only take images or videos of my children, and will not publish any images or videos that contain other children without the express permission of their parents/ care givers.

Authorisations and Expectations

give permission for my child to attend all scheduled activities, unless I advise the Team Leader otherwise.


I authorise the Kids or Youth 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 acknowledge that being part of a community involves mutual care and consideration, and therefore agree that unacceptable behaviour may result in my child being sent home and being temporarily or permanently prohibited from attending the activities of Burnie Anglican Church.

 

I will provide the Team Leader with any information relevant to the wellbeing of my child prior to him or her attending an activity. This might include supporting documentation (eg AVO, Family Court Order) if there is anyone who is legally restricted from seeing your child.

 

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

Child

We will keep these details on file so that we do not have to ask for them prior to each event, unless you request otherwise. Please advise the Team Leader or Church staff as soon as practical of any changes to this information.

Programs Attending

Medicare Details

IMPORTANT: Medicare details are required for registration to all activities where parents do not accompany their children (i.e. KLT, Min-Makers, Youth Group). 

 

Medicare details are not required for Playtime, as parents are present with their children. 

Authorisations

In addition to the people (parents/ caregivers and emergency contact) listed above, I authorise the following people to sign in and sign out my child from any kids' ministry program at Burnie Anglican Church.

Is there anyone who is legally restricted from seeing your child?

Medical and Care Needs

Please indicate any medical conditions that Team Leaders should know about.

Do you give permission for your child to take paracetemol if required?

Please indicate any special needs or specific care needs that we should know about to provide the best duty of care for your child.

Please also provide any helpful strategies that work with your child.

Dietary and Allergies

Does your child have any special dietary requirements or allergies that we should know about?

Swimming

Can your child swim 30m unassisted?

Please provide any further details you consider relevant:

For Youth only

Optional, for leaders to use to contact.

Do you authorise your child to make their own way to and from Youth Group?

Images and Video

I agree that I will only take images or videos of my children, and will not publish any images or videos that contain other children without the express permission of their parents/ care givers.

As a church that seeks to reach out to the community and offer glimpses of parish life, we occasionally require images of people to publish on church media. In our particular church context, this might include (but not be limited to): website, brochures, social media, signage etc. We would love for you to be willing to be part of our media, but we understand that sometimes this is not preferable for many people. We want to invite you to allow the church create and use your image for the above purposes. You can allow this by filling out this section of the form for your family. It allows you to indicate some or all of your family members with whom images are able to the used. We ask that both parents sign where this is possible (even if one or both parents are preferring their photos not to be used).

Will you get to check the photo before publication? Yes. If a photo that contains your image is chosen to be published, we will check with the people in that image to make sure they are okay with the particular image being published.

What am I permitting exactly? 

We require two sets of permission:
1) Permission for the ‘
creation’ of an image (including video)(i.e. the taking of a

photograph and the storage of the photograph on a hard drive)
2) Permission for the 
use’ of an image (i.e. the publishing, or projection of an image).

You can also indicate that you wish to limit your photo publication to the parish directory only.