Kids Church Registration 2016
Please use this form to register your child for the Redlands Presbyterian Church Kids Church Program 2016 at the Redlands Presbyterian Church.

If you'd like more information about us, or need help with this online form please contact our coordinator, Jen (0422 842 202) or check out our website.

First Name
Your answer
Last Name
Your answer
Gender
Date of Birth
Your answer
Address
(of the child)
Your answer
Email Address
This will not be given to a third party, but will be used exclusively for the purposes of kids church.
Your answer
School year
Who will be collecting your child?
Please indicate who will be coming to pick up your children from the program. If it is a childcare centre, please indicate that here.
Your answer
Do you consent to appropriate use by us of photographs taken on the program that include your child?
For example, inclusion in our newsletter, or placement on our web page or in a brochure. Please note that these refer to photographs of group activities. There will be no individual photos taken.
Emergency Contact Details
Emergency Contact Name
Your answer
Relationship
What is the relationship of the Emergency Contact person to your child?
Your answer
Emergency Contact Phone Number
Your answer
Next
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