Kids In The Kitchen Registration

Please note that the information on this form is for the sole use of Spring Bay Pentecostal Church and is not available to any other individuals or groups. This means that we will not disclose any of the following information to another individual without your permission.

General Consent Form for Sept 2025 to Aug 2026

Parent/Guardian's First name

Parent/Guardian's Last name

Phone

Address

Child(ren)'s names with birthdays

Health Card Numbers

Emergency Contact Name with Phone Number

Second Emergency Contact Name with Phone Number (Optional)

Are there any medical conditions (i.e. allergies, epilepsy, asthma, diabetes, etc.) which we should be aware of?

Please give any details of special dietary needs we should be aware of (e.g. food allergies).

Please check the box if you do not want the use of pictures containing your child to be used for promotional purposes or on social media.

I. the parent or guardian, gives my child(ren) permission to attend and participate in this activity. I understand that care will be taken to ensure the health, safety, and welfare of my child. I realize and accept that in the event of my child's behaviour adversely affecting the safety of the activity, the organizers reserve the right to return my child home.

Signature

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