Communities & Teams Events Check-In Directory Log in

Adelaide Place Kids Consent Form

This form should be completed by someone with parental responsibility for the child.
Please complete a new form for each child. Thank you!

Your name *

Last name

Email address *

Phone number *

Phone type

Alternate Emergency Contact (Name and relationship to child) *

Phone number *

Phone type

Child's Details

Child's Name *

Preferred Name (if different from above)

Date of birth *

Gender *

Male

Female

Please give details of any siblings & their age

Does your child have any allergies or other dietary requirements? *

Yes

Does your child have any medical conditions of which we should be aware? *

Yes

Does your child have any additional support needs of which we should be aware? *

Yes

Medication Consent

Does your child have any medication that we may need to administer eg. an inhaler or epipen? *

Yes

General Consent

I give permission for my son/daughter to take part in the normal activities of Adelaide Place Kids groups on a Sunday.

Photograph Consent

During the course of our regular activities we may take photographs to be used both on the church website and in future event publicity. In order to publish an image of your child we need parental permission. All such photographs will be handled in accordance with our Child Protection Guidelines and we will NOT publish any names or personal information.
NOTE: If you do not give permission for your child’s photo to be published, please make sure that your child is aware of this.

I grant permission for Adelaide Place Baptist Church to publish images of my child on Adelaide Place website, social media and weekly emails.

Any other information which may be relevant for Adelaide Place Kids Team

Thank You

If there are any changes to the details on this form, please inform the group leader immediately. This form should be completed annually and will be retained in our records in accordance with our Child Protection Policy.

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Adelaide Place Baptist Church
hello@adelaide.place
07726906544