Holiday Kids Club Eternal Piece 2025 • St Peter's Connect

9am-12pm Daily

Registration opens at 8:30am

Date

7 July, 2025 - 10 July, 2025

72 out of 85 remaining tickets available

Type

Price

Quantity

Kids Club

Price
$0.00

Quantity

Kids Club 0

Registration Form

Child's First Name *

Child's Last Name *

Child's Date of Birth

School year *

Days Attending Kid's Club 2025

Monday 7th July Eternal Piece Kid's Club

Tuesday 8th July Eternal Piece Kid's Club

Wednesday 9th July Eternal Piece Kid's Club

Thursday 10th July Eternal Piece Kid's Club

Tip: This is to give us a rough number. Ok if things change.

If you attend church, let us know where

Mailing Address *

Suburb *

State

Postcode *

Parent/Guardian #1 Name *

Relationship to Child *

Parent/Gaurdian #1 Phone *

Email Address *

Parent/Gaurdian #2 Name

Relationship to Child

Parent/Gaurdian #2 Phone

Alternative Emergency Contact

Please provide an alternate contact, different from above.

#1 Alternate contact - Name *

Relationship to child

#1 Phone *

Person/s Authorised to collect your child if not parent/gaurdian

Medical Information

Does this child have any allergies? *

Yes

If Yes, please provide details AND bring a copy of their action plan.

Does this child have asthma, diabetes, epilepsy or other medical condition? *

Yes

If Yes, please provide details AND bring a copy of their action plan.

Please note any medication and storage instructions.

Can this child self-administer their medication?

Yes

Does this child have any dietary restrictions? *

Yes

If Yes, explain...

Does this child have any restrictions from physical activity? *

Yes

If Yes, details please...

Is there anyone who is legally restricted from contact with this child? *

Yes

If so, please provide name and other relevant information.

Are there any other medical/behaviour issues you believe we need to be aware of whilst taking care of this child? *

Yes

If so, please note here, or speak with our registration team.

Permission

In checking the boxes below, I indicate permission for this child: *

To participate fully in the 'Eternal Piece!' Holiday Kid's Club, undertaken by St Peter's Anglican Church Tamworth, at 34 Vera St from Monday 7th to Thursday 10th July, 2025, from 9am-12pm each day.

I understand that photos and video will/may be taken during the course of the holiday kid's club, for use in promotional material, in the context of supporting the ministry (e.g on a brochure for the group, in local papers) without identifying their name or details. I am willing for my child to be photographed/filmed in the appropriate setting over the course of the holiday kid's club.

In the unlikely case of illness or accident, I hereby give permission for any appropriate first aid to be given by the nominated first aid officer. In an emergency, I give permission to secure proper treatment for and/or hospitalisation, injection, anaesthetic, or surgery for my child as named. I understand that every effort will be made to contact me prior to instituting such procedures.

I further authorise the use of an ambulance if deemed necessary by the first aid officer . I accept responsibility for payment of all expenses associated with such treatment.

By typing your name and submitting this form, certifies acceptance of the above checked conditions: *

Date *

Relationship to child *