Blast Kids Club Registration Form

Thank you for registering your children for Blast Kids Club.

The details you provide here enable us to love & care for your children throughout the year.
No information will be released to the public and all data is securely stored by The Point Community Church.

All fields marked with an asterisk (*) must be filled in.

Parent/Guardian/Carer Contact Information

Primary Emergency Contact Name *

Tip: Please provide your full name

Emergency Contact Mobile Number *

Email Address *

Home Address *

Home City *

Home State *

Home Postcode *

Child's Information

First Name *

Last Name *

Gender *

Date of Birth *

School *

School Year *

Church child attends *

Which Church?

Photo/Media Restrictions

I consent to photo/video of my child being taken and used on the The Point Community Church website and/or for promotional material. *

I Consent

I Do Not Consent

Medical & Dietary Information

My child has allergies, medical conditions or additional needs *

Medical, Additional Needs & Dietary Notes

Disclaimer

By clicking 'submit' I confirm that:

all the details provided my myself are accurate & true.
By submitting this form, I agree to release this information to the use of The Point Community Church as they care for & teach my child/ren.