Kids Registration

Berry Kids Registration

This form is to be completed by the parent or guardian of the child attending Berry Kids. (Please fill out one per child.)

* Indicates required field

First Name *

Surname *

Grade *

Date Of Birth *

Gender *

Male Female

School *

Address *

Suburb *

Postcode *

Parent 1 Name *

Phone number *

Email *

Parent 2 Name *

Email *

Phone number *

Allergies/Medications *

Please indicate Y/N

I agree to photographs and videos of activities including my child to be taken for use within the church community (not on the internet). *

Yes No

I agree to photographs or videos of activities including my child to be shown on church social media & website. *

Yes No

I give permission for

Name Of Child *

to be in Berry Kids programs with approved leaders from South Coast Life Church

Name (Parent/Guardian) *

Date *

Submit