Kingsley Youth Registration Form • Kingsley Church of Christ

Please complete this registration form so that we have all the information we need to best care for your child whilst they are at Kingsley Youth.

Child Information

Child Information 2

Child Information 3

Responsible Adult Contact Information

First & Last Name: *

Mobile Number: *

Email Address: *

Home Address:

Tip: (optional)

I consent to receiving communication about Kingsley Youth to my:

Mobile

Tip: Please select all that apply

Would you like to add an additional contact? *

Yes

Responsible Adult Contact Information 2

First & Last Name: *

Mobile Number: *

Email Address:

Home Address:

Tip: (optional)

I consent to receiving communication about Kingsley Youth to my:

Mobile

Tip: Please select all that apply

Other helpful information

Are there any Custody Restrictions/Court Orders currently in place for any children included on this form? *

Yes

Is there any other information or comments you would like to include with this form that will help us care for your child(ren)? Please include them here:

Fees

Kingsley Youth attendance fees can be paid weekly or per term. Fees are as follows:

$4 per week per child

$30 - upfront for 1 child for the term

$50 - upfront for 2 or more children for the term

Weekly fees can be paid by cash or card at Youth on a Friday night.

Upfront fees can be paid by cash or card at Youth on a Friday night or can be paid online via EFT or credit card. Online payment details will be emailed out once registration has been confirmed.

If required, alternative payment arrangements can be organised after the registration confirmation email has been sent out.

Consent

The Church may from time to time record video or images of services & activities for promotional, teaching & information purposes. By attending church services & church activities you consent to the church taking the video & images and using & disclosing them for such purposes.

Please select one: *

I consent for my child to be included in photos or video recordings of church activities.

I need to talk to someone to arrange for my child to not be included in photos or video recordings of church activities.

By submitting this form, I acknowledge that although all care and supervision is taken, the leaders are free from responsibility for any accident, injury or illness arising in the course of activities. In the Event of any accident, injury or illness, the leaders are authorised to obtain necessary medical assistance, for which I will meet all expenses.