Kids Ministry Registration Form

Please note that this form registers your child(ren) for Mayfield Baptist Kids Programs at Mayfield Baptist Church.

This is required for your child(ren) to attend Mayfield Baptist Kids Programs this year. Other external events or programs may require a secondary registration for that specific event.

Currently, the programs on Sundays during the Morning Service, are:

Ages 2-5 - Little Embers Program
Kindy - Year 6 - Embassy Kids Program

Thank you for registering.

Blessings from the Mayfield Kids Team

Information Form Completed By (Parent/Legal Guardian): *

Child/ Young Person's First Name *

Child/ Young Person's Last Name *

Date of Birth *

Gender *

School Grade *

Parent/Carer's Name *

Parent/Carer Phone Number *

Parent/Carer Email Address *

Mobile Number (Primary Contact) *

Tip: This will be the number the church contacts

Address *

City *

State

Postcode *

Medical Information

Are there any allergies, dietary requirements, physical needs or medical issues we should be aware of? *

Tip: If yes, please provide further details/action plan.

If you have an action plan for management of anaphylaxis, asthma or any other condition please provide a copy via email to kids@mayfieldbaptist.com so that leaders can be made aware of it.

Food Intolerances

Allergies

Medical issues/physical needs to be aware of

Emergency Contact Information

Alternative contact details in case we are not able to contact you in an emergency. This should be a person whose details are not already recorded on this form. (Please inform this person that you have submitted their details)

Emergency Contact Name *

Emergency Contact Phone *

Emergency Contact Relationship to the child/ young person

Permissions Given

Do you give permission for your child/ young person (named above) to attend Mayfield Kids?

Consent for details to be stored by the church *

Consent Parent/Carer to be contacted by group leaders or the church office by: *

Phone

SMS

None

Photography and Video

On occasion, photos or videos may be taken by leaders to capture events. The photos may be used for things such as digital or physical displays, the church website, the church's social media profiles. We respect the privacy of our children and young people, so if you wish for your child or young person not to be photographed in this way please let us know below.

Image Use

External Use Not Allowed

Internal Use Not Allowed

In Case of Emergency

I understand that in the event of an emergency, it is the church's intention to make every effort to contact the people listed as the emergency contacts. However, if contact cannot be made, I give permission for my child to receive ambulance, medical, surgical or anaesthetic care as required, and I accept full responsibility for all expenses incurred.

Relationship to the Child/ Young Person *

Information Form DATE completed: *

Tip: By completing this section you agree the above information is true and correct. (Year in which the form is signed is the year student is registered for).

Thank you for providing this important information. We will store your details in accordance with the Recordkeeping section of our Safe Church Policy which can be found on our website along with our other Policies and Procedures: https://www.mayfieldbaptist.com/safe-church

Feedback- Please use the space below to note any feedback, suggestions, questions or concerns you may have.