Youth and Children's Registration Form

Registration Form for Mosman Village Church Youth and Children's Community

Student Infomation

Please complete this form for your child. The information on this form will only be seen by staff and volunteer leaders of Mosman Village Church, and will be used to provide quality care and teaching for your child.

First Name

Last Name

Preferred Name

Gender

Date of Birth

School Grade in 2022

School Attended

Swimming Ability

Medicare Number

Tip: Please provide your child's medicare number and suffix

Allergies and other relevant Medical Conditions

Are there any people who are prohibited by court order from access to your child?

Siblings Name and School Year

Contact Infomation

Contact Parent's Name 1 *

Contact Parent's Mobile

Contact Parent's Name 2

Contact Parent 2's Mobile

Email Address

Home Address *

Home Address Line 2

Home City *

Home Postcode *

Mailing Address

Tip: If different from Home Address

Mailing Address Line 2

Mailing City

Mosman Village Church's photography policy is to have one designated photographer at youth and children's events. The photos taken are used only for internal advertising, unless express permission is obtained from a parent or guardian for use of an image in external media. No image of a child will be uploaded online without the express permission of a parent or guardian. It is not permitted for children to upload images of themselves or other children at a Mosman Village Church youth or children's event without permission of a parent or guardian of each child shown in the image. By completion of this form you indicate your acceptance of these conditions.

Mailing Postcode

Anything else we should know?

Please let us know of anything else that you consider important for your child eg custody arrangements