UniHill Kids Church Registration Form

Your name *

Last name

Email address *

Relationship to Child

Birthdate

Address

Country

Street Address

Apt/unit/box (optional)

City

State

Postal code

Phone number *

Phone type

Household members

The information provided on this form is correct and I accept it is my responsibility to inform the Unihill Kids Department should any changes occur. *

Yes

I am willing for my child to participate in all activities offered in the program. I agree that it is my responsibility to familiarise myself with the program and to advise staff if I do not with my child/ren to participate in an activity. *

Yes

I realise that it is my responsibility to inform the program if my child/ren contracts any illness that could be detrimental to the health of others at the program. *

Yes

I accept that program staff will maintain appropriate standard of supervision and safety, but that the program accepts no responsibility for accident, illness or damage to property due to any program activities. *

Yes

In the event of an accident or illness associated with my child/ren, I give permission for the required emergency medical assistance to be given to my child/ren on my behalf and agree to meet any expenses associated with that medical assistance. *

Yes

I further authorise Uni Hill staff to act on my behalf, where I cannot be contacted, to obtain any ambulance service that my child/ren may require and agree to meet any expenses attached to this service. *

Yes

In case of emergency, where I cannot be contacted, I agree to my child/ren being transported by private vehicle. *

Yes

I am willing for my details to be shared with other church departments that may have services that suit my family. *

Yes

Photo Consent

Please note: During our events your child may be photographed, or video footage taken for internal promotional and display purposes. It is a condition of entry that each audience waives and claim he or she might have in relation to inclusion of their likenss in such films or recordings.

Internal Use: I understand that photos may be taken during the program and undestand that Unihill Church may use photographs or other media images its representative has taken of my child, with or without others, whole or in part, for promotional and diplay purposes within UniHill Church (for internal display and promotion).

Internal Use *

Yes

Photo Consent External

External Use: I understand that Unihill Church will occasionally want to use images for external promotion and I explicitly grant the absoute right and permission to Unihill Church to use these images. I understrnad that the images may be altered, and I waive the rights of approval of any finished product.

External Use *

Yes

I release and indemnify Unihill Church from any loss or damage or any claims whatsoever that arise out of the use of my child's image. *

Yes

I give permission for Unihill Church to use my contact information provided in this form to inform me of church events via e-mail and text message. Please note, you can unsubscribe from our mailing list at any time. *

Yes

Privacy Policy

Please note: all information gathered from you will be used in accordance with our privacy policy. Our privacy policy can be found here: https://www.unihillchurch.com.au/policies/privacy-policy/

Date of Acknowledgement *

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UniHill Church