NextGen - Registration • Beaconsfield Baptist

We're so glad your child is joining us at NextGen. We'd love a few basic details so we can check your child in, contact you in an emergency and keep you up to date with events.

Child's Details

First Name *

Last Name *

Date of Birth *

School Grade *

Gender *

Home Address

Home City

Parent/Guardian/Emergency Contact details

Name *

Relationship to Child *

Mobile/Phone Number *

Email Address *

Permission, Medical and Consent

Can your child self-checkout? *

Tip: If no, please list the names of additional people who are authorised to collect your child.

Authorised Person #1

Relationship to Child

Mobile

Authorised Person #2

Relationship to Child

Mobile

Please give details of any person/s legally not permitted to contact your child:

Please list any physical or special needs or other relevant information:

Tip: (i.e. allergies/intolerances or existing conditions) This information will be destroyed when no longer required.

Do you give permission for your child to be photographed and/or recorded during the course of the activity? *

Tip: For the purposes of creating promotional material for the church and/or its ministries.

I consent to my child participating in nextgen. I will encourage my child to attend and participate regularly and to cooperate with the leaders and other children. I acknowledge that I am responsible for my child at the conclusion of the service each week (approximately 11:15am).

I authorise the leader/s in charge of nextgen to arrange for my child to receive such first aid or medical treatment as the leader may deem necessary at any time during the activities. I further authorise the use of an ambulance if necessary and I accept responsibility for payment of all expenses associated.

I agree to indemnify and hold harmless the Baptist Union of Victoria, Beaconsfield Baptist Church, and any individual staff or voluntary leaders against all claims arising out of any injury to the child, and the relevant activity being undertaken unless such injury results from a failure in the duty of care of the Baptist Union of Victoria, the church, or any individual staff or voluntary leader.