Rhema Kids Registration

Child's Details

Given Name *

Family Name *

Home Address *

Home Suburb *

Home Postcode

Home State

Mobile Number

Parents' / Caregivers' Details

Carer's Name *

Carer's Mobile Number *

Relationship to child *

Best Email Address for updates *

Further Details

Does your child have any Allergies? *

Does your child have any known medical conditions that we need to be aware of? *

Does your child have any special needs we need to be aware of? *

Family Home

Do both parents of the child live together?

Yes

If "no" who does the child live with most of the time?

Mother

Father

Are there any custody agreements we need to be aware of?

If "yes" please explain how you would like us to manage these restrictions.

Conditions of Involvement

As a condition of your child's involvement in Rhema Kids, please indicate you agree to the following with a tick in each box below.

I will remain in the Rhema Family Church facility while my child is in Rhema Kids. *

Yes

I will be responsible for signing my child in and out of the Rhema Kids Services. I must sign my child out of Rhema Kids, within 15 minutes of the close of each service. *

Yes

Even though every effort will be taken to ensure the safety of my child whilst at the facility, Rhema assumes no responsibility for any injury sustained. *

Yes

A First Aid Attendant may administer first aid to my child, should it be deemed necessary by Rhema. *

Yes

Rhema may assist my child from the building to a safe assembly area should an emergency arise. I will be reunited with my child once a Rhema Kids leader has completed a roll call. *

Yes

I give permission for my child to have photos and videos taken to be used for public display (including social and digital media and Rhema related websites) *

If you have more than one child to register, complete a separate form for each child and click "submit another response" each time. Thank you for taking the time to help us get to know you. This will enable us to care for and minister to your child in the best possible way. We look forward to getting to know you and your family.