Kids and Youth Registration 2023

If your child is in our Elvanto database already, you can update their details by going to this link (make sure you are logged in to Elvanto): https://stmarksberowra.elvanto.com.au/profile/family/

Tick this box if you have already checked Elvanto, and updated the details for your child.

The details for my child are up to date

Application

Please indicate which programs your child is likely to attend during this year *

E3: Friday night youth group (Year 7 - 12)

Kids Club Friday afternoon group (K to Year 6)

Playtime (0 - 5 yrs)

Frogs / Creche: 0 - 5 year olds

Oasis: K - Yr 6

Details of Child

Child's First Name *

Child's Last Name *

Date of Birth

Gender

Child's Email Address

Phone Number (Home)

Home Address

City

Post Code

Address Line 2

State

School Grade

School

Parent/Guardian information

1.Parent/guardian name *

1. Mobile Phone *

1. Parent/guardian email address *

2. Parent/guardian name

2. Mobile Phone

2. Parent/Guardian email address

Name of anyone legally restricted from seeing the child

Church attended (if not St Mark's)

Child's Health Information

Emergency Contact (if parent/guardian cannot be reached)

Emergency Contact Phone

Details of Family Doctor

Describe in full any allergies (drugs, food, environment) and the medication taken

Any health or other issues we need to know about including dietary restrictions, medication, disability etc

If the child is restricted from any activity, please note the restriction and specify the condition involved

Additional information (if any)

Permission for photos/videos of child to be used for St Mark's ministry purposes (including being displayed publicly in print and online material) *

Yes

PARENTS, PLEASE READ, SIGN AND DATE BELOW

Participation, Privacy and Medical Consent

Privacy

My signature below indicates permission for my child to participate fully in any age-appropriate youth / children’s activities associated with the parish church of St Mark’s Anglican church, Berowra.

In case of a medical emergency, I give consent for the church authorities, or other persons supervising or administering the youth/children’s activities, to obtain, at my expense, any medical, hospital, ambulance, rescue or other services that are considered necessary for my child. I understand that every effort will be made to contact me prior to instituting such actions.

I understand that the personal information shown on this form will be treated confidentially, and will only be used in accordance with the terms of the Privacy Policy set out on the St Mark's Berowra website. If you wish to access your personal information, or have any queries in relation to the manner in which we handle it, please do not hesitate to contact us.

PARENT OR GUARDIAN'S SIGNATURE *

Signature (First and Last Name) *

Date *