Family Consent 2024 • Toongabbie Anglican Church

Family Address

Address *

Suburb *

Postcode *

Home Phone

Parent/Caregiver 1 Name *

Parent/Caregiver 1 Email Address *

Parent/Caregiver 1 Mobile Number *

Relationship to child(ren)

Parent/Caregiver 2 Name

Parent/Caregiver 2 Email Address

Parent/Caregiver 2 Mobile Number

Relationship to child(ren)

Emergency Contact (alternative to parents/caregivers) Name, Number, Relationship to child *

Tip: eg. Rachael, 0412 345 678, Family Friend (this is some one we will contact in an emergency, if we can't get in contact with either parent)

Child Details

First Name *

Preferred Name

Last Name *

Gender

Date of Birth *

My child is at preschool/school

Yes

School *

School Grade *

Child's Email Address

Tip: If applicable

Child's Mobile Number

Tip: If applicable

Medical conditions we should know about (medication, chronic illness, allergies, other):

Special care needs we should know about (such as behavioural concerns):

Dietary needs we should know about:

Do you authorise your child to make their own way to and from church events (for One80 only)?

Is there anyone who is legally restricted from seeing your child? (If yes, please provide documentation, e.g. AVO or Family Court Order)

Any other comments?

Please read these statements carefully:

I am aware that this group is organised and run by Toongabbie Anglican Church and understand that there will be Christian content in some activities.

I consent for my child(ren) to participate in all organised activities.

I consent for them to receive medical aid in the event of any accident or sickness and agree to pay any fees thus incurred. I understand that personal accident insurance is my responsibility, and that Toongabbie Anglican Church and its representatives accept no liability for any accidents.

I understand that my child(ren)’s basic information may be accessed by those in the church community with up-to-date working with children and safe ministry accreditation. Personal information may also be made available to medical and emergency services if considered necessary.

I acknowledge that being part of a community involves mutual care and consideration, and therefore agree that unacceptable behaviour may result in my child being temporarily or permanently prohibited from attending the group.

I will provide the leaders with any information relevant to the wellbeing of my child. This might include supporting documentation (eg: AVO, Family Court Order) if there is anyone who is legally restricted from seeing my child.

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

Please speak to the Children's Pastor - Rachael Nash if you have any concerns. (Rachael: 0405 679 703, rachael@tac.church).

I accept and give consent *

Yes

For all children and youth under 18 years of age:

I understand that photos/videos of my child(ren) may be taken at church events and displayed publicly (online and in print) unless I inform the church otherwise in writing - let us know in the additional comments section of this form.

Photography Consent (kids/youth) *

Yes

For youth in Years 6-12 only:

I give consent for my child(ren) to be driven by someone with a provisional P2 license (green P-plates) or above. If fully licensed drivers only, please let us know in the additional comments section of this form.

I accept and give consent

Yes

For youth in Years 6-12 only:

I give consent for my child(ren) to attend off-site activities as advised in advance.

Consent to go offsite (youth)

Yes

Date *

Signature *

Tip: Please type your full name to sign this form