Kids Connect Holiday Program 2018
Canterbury Gardens Community Church invites you to join us for our Kids Connect school holiday program!
Child's First Name *
Your answer
Child's Last Name (Family Name) *
Your answer
What days will you attend? *
Child's Birthday *
Emergency Contact
Please give details of a contact available during the mornings of the Kids program, and may be contacted in case of a medical situation or emergency. Please note, emergency contacts must be over 18 years of age.
Emergency Contact Name *
Your answer
Relationship to child *
Phone number *
Your answer
Medical Considerations
Please list any dietary restrictions or medical considerations which are relevant to ensuring the safety and wellbeing of your child during this holiday program.
Any medication which may need to be administered during the time of the program (e.g. Asthma inhaler, EpiPen) will need to be delievered to the first aid officer in charge, and signed in upon arrival at the program. Any such medication will be administered by the first aid officer in charge, if required.
Dietary Restrictions *
Other Medical needs/considerations
Your answer
Photograph Permission
During this holiday program, photographs and/or video footage may be taken of your child. These photos may be used to promote future children's events at Canterbury Gardens Community Church (CGCC). All photographs and footage will be collected, stored and used in accordance with CGCC's privacy policy.
Further Contact
At CGCC, we would love to stay in touch with you and let you know of future church events which might be of interest to your family. If you would like to be added to our mailing database then please fill out your details below
Full name
Your answer
Email address
Your answer
Residential address
Your answer
Phone number
Your answer
Our family includes...
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