Child registration form Playtime 2024

Thank you for registering your child for St Stephen's programs in 2024

Please pre-register your children using this form. To find out more about our programs check out st-stephens.com.au/kidsandyouth/

Child's details

First Name *

Last Name *

Date of Birth

Gender *

Home Address *

School Grade

School

Allergies / Relevant Medical Conditions *

Prohibited Persons

Additional Needs

At St Stephen's, we welcome all young people as part of our programs, no matter their abilities and needs. We invite young people to come as they are and to grow in their love and knowledge of God, including young people who have additional needs due to physical impairment, developmental delay, mental, emotional or communication disorders and/or ongoing health challenges. We'd be glad to speak further with you about any ways we can be partnering with you to provide helpful care and support for your children - just let us know below that you'd like to speak further with a staff member.

I would like to speak further to someone

Details of our child's additional needs/ anything that it would be helpful for our team to know in caring for your child

Parent or Guardian Contact Details

Emergency Contact Name *

Emergency Contact's Relationship to Child *

Emergency Contact Number *

Email Address *

Alternate Contact (Parent or Guardian)

Relationship to Child

Mobile Number

Email address

Permissions

I consent to photos and/or videos of this child being taken and used for activities directly related to the wider St Stephen’s Ministry. This may include promotional materials.

Photo Permission *

Yes