Kids and Youth Registration 2026 • St John's Asquith

Introduction

At St John's, we want to care for your children well. Part of that is making sure that we have up-to-date, relevant information for each of your children.

This form is to be completed for all children under 18 years attending children's and youth programs at St John's Anglican Church Asquith, and should not take more than 5 minutes per child to complete.

The personal information in this form will be made available to:

a) the leaders involved in the running of activities for children and youth at St John's Asquith

b) medical and emergency services if considerred necessary.

The first section of this form collects details for the whole family.

You will then need to enter specific details for each child under 18 in your family, by choosing 'add another family member' at the bottom of the form.

While we have tried to make the form as user-friendly and intuitive as possible, the constraints of the database itself mean that you will need to repeat some of the questions such as parent details, emergency contacts and the approvals and permissions for each child separately.

Family Information

Last Name *

Address *

Suburb *

Postcode *

Primary Parent/Caregiver Information

Parent First Name *

Parent Last Name *

Mobile Number *

Email Address *

Secondary Parent/Caregiver Information

Secondary Parent First Name

Secondary Parent Last Name

Secondary Parent Mobile Number

Secondary parent Email

Child details

The details provided here will help us to get to know your child, and alert us to any specific medical, dietary or other needs.

First Name *

Last Name *

Date of Birth *

Gender *

School

School Grade

What are your child's interests? *

How does your child best learn? *

Does your child have any needs that we should know about? *

Tip: This is where you can tell us about medical, dietary or other care needs

Medical Needs

Prescription medication

Chronic Illness

Medical Allergies

Tip: Please provide details in the section below marked "other information"

Dietary issues (eg food allergies)

Tip: Please give details here.

Care Needs

Behavioural concerns

Psychiatric care

Neurodiversity

Other

Tip: Please provide details in the section below marked "other information"

Other information

Tip: This is where you can give details of medical, dietary or other care needs

Emergency contact (other than a parent)

Emergency Contact Name *

Emergency Contact Relationship *

Emergency Contact Phone *

Agreement and Permissions

St John's Asquith is exempt from the requirements of the Privacy Act 1988 (Cth) as it is a "small business". However, we seek to deal carefully with the personal information we collect and to do so in a manner consistent with your reasonalbe expectations. More information is set out in our privacy policy on our website.

I give permission for photos/video of my family to be shown within St John's church eg during a Sunday service *

I give permission for photo/video of my family to be shown publicly e.g. St John's Church website, digital signboard, social media *

I give permission for my child to attend all scheduled activities held at St John's Asquith, unless I advise the leaders otherwise. *

I understand that a separate activity form will be required for any activities held off-site *

I understand that leaders will provide supervision of my child for the duration of the program or activity, and I will ensure that a parent or guardian will pick up my child at the conclusion of any activity or inform leaders of appropriate alternate arrangements *

In the event of an emergency, I authorise the leaders to obtain at my expense any medical, ambulance, rescue or other services that are considered necessary for my child. *

I acknowledge that being part of a community involves mutual care and consideration, and there agree that unacceptable behaviour may result in my child being sent home and being temporarily or permanently prohibited from attending activities. *

Is anyone legally restricted from seeing your child? *

Yes

Legal restrictions

I confirm that the information given in this form is true and correct, and will advise of any changes to this information. *

Authorisation *

Tip: Please type your name here to act as a signature