mainly music registration • C@P & CCM

This information is being collected for the sole purpose of mainly music.

The details are necessary to meet child protection requirements, so please complete all fields.

Your details will also be used to advise you of upcoming mainly music events and relevant activities run by Church@thepeak.

Parent or Primary Carer

Please complete details of the primary parent or caregiver of the child(ren).

First Name *

Last Name *

Gender *

Date of Birth (day/month) *

Relationship to Child(ren) *

Is this the adult who will attend mainly music? *

Home Address *

Home City *

Home Postcode *

Email Address *

Mobile Number *

Children Attending mainly music

Please complete for all children who will be present at mainly music including babies.

Child 1

First Name *

Last Name *

Gender *

Date of Birth *

Child 2

First Name

Last Name

Gender

Date of Birth

Child 3

First Name

Last Name

Gender

Date of Birth

Adult who will attend mainly music (if different to above)

Complete this field for an adult who will regularly attend mainly music if different to the primary carer above.

Last Name *

First Name *

Relationship to child(ren) *

Mobile phone no. *

Email address *

Emergency Contact (Secondary contact - not the same person as the primary carer)

First Name *

Last Name *

Mobile Number *

Relationship to Child(ren) *

Additional Information

Is there anything we should know? E.g. Allergies, medical conditions, special needs.

Please select either yes or no

If you answered "Yes" please provide details below.

Details about special needs.

How did you find out about mainly music?

Church affliation (if any)

Social Media and Photography

Photos of families at mainly music cannot be used on any social media site unless they are only of your child(ren) or when you have received the direct permission of the parents of other children. Filming of a portion of a song is ok, but an entire song is prohibited by the mainly music organisation.

From time to time photos are taken of the fun we have at mainly music. These may be shown occasionally to the members of Church@thepeak to keep them informed - who support this program and enable it to happen. They may also be used on the mainly music Peakhurst Facebook page, which is a closed group.

Agreement

By submitting this registration form, I understand that during mainly music, parents/carers are expected to remain with and take responsibility for the child(ren). Although the mainly music team take all reasonbale care, there are still risks to manage.

I also understand that mainly music has illness, safety and behaviour policies which will be provided to me when a place is available. When I attend mainly music, I agree to follow these policies.

I agree with the above. *

We look forward to meeting you at mainly music Peakhurst.