Kids Church Registration • C@P & CCM

All field must be completed to comply with Safe Ministry standards of the Anglican Church of Australia.

All Church@thepeak children's ministry leaders undergo regular Safe Ministry training and have obtained Working With Children Check.

Last Name *

First Name *

Gender *

Preferred Name *

Date of Birth *

School Grade *

Please specify if your child has an additional need *

Please provide details below, including any action required.

Family Name *

First Name *

Email Address *

Mobile Number *

Home Address

Mailing Address

Home Address Line 2

Mailing Address Line 2

Home City

Mailing City

Home State

Mailing State

Home Postcode

Mailing Postcode

Surname *

First Name *

Relationship to Child *

Emergency contact mobile no.: *

Name

Mobile no.

Name

Mobile no.

Submission of this form indicates permission for my child to participate in children's ministry activities of Church@thepeak.

I understand that:

Whilst all reasonable care will be taken, I accept full responsibility for the welfare of my child.
In an emergency, I understand every effort will be made to contact myself or the emergency contact person.
I give permission for my child to receive appropriate medical aid if the need arises, and paramedic assistance in the case of an emergency.
I understand at times my child may be photographed, and the photos used by Church@thepeak.