Parental Consent Form

This form is for information about children and young people attending Chinchilla Church of Christ programs that are under the age 18yrs. It is to be completed by the parent/guardian/carer and returned to a Chinchilla Church of Christ progrm leader before child attends for the first time.

Collection Permission
Child 1
Programs Child will be attending Please select all valid programs
Details of any known allergies (including any medication):
Details of any other information you feel would be helpful for the leaders to know about your child:
Child 2
Programs Child will be attending Please select all valid programs
Details of any known allergies (including any medication):
Details of any other information you feel would be helpful for the leaders to know about your child:
Child 3
Programs Child will be attending Please select all valid programs
Details of any known allergies (including any medication):
Details of any other information you feel would be helpful for the leaders to know about your child:
Child 4
Programs Child will be attending Please select all valid programs
Details of any known allergies (including any medication):
Details of any other information you feel would be helpful for the leaders to know about your child:
Child 5
Programs Child will be attending Please select all valid programs
Details of any known allergies (including any medication):
Details of any other information you feel would be helpful for the leaders to know about your child:
Child 6
Programs Child will be attending Please select all valid programs
Details of any known allergies (including any medication):
Details of any other information you feel would be helpful for the leaders to know about your child:
Collection
(Please remember that your child is not allowed to leave a program unaccompanied)
Concent

I give permission for my child to attend the Chinchilla Church of Christ Kids Church. By allowing my child to attend I give permission for my child’s details to be stored by Chinchilla Church of Christ (this may be on computer or in the Cloud) for Kids Church and Church Safe legal requirements and purposes as considered necessary.

I understand that every reasonable effort will be made to contact me as soon as possible.

Chinchilla Church of Christ

16 Villiers Street

Chinchilla

Queensland 4413

Call Us (07) 2146 9337

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