Child's Information


Which of our kids programs may your child attend this year?


Child's Home Address


Medical & Safety Information


Parent/Carer Information

Parent/Carer 1


Parent/Carer 2


Emergency Contact Details

If we are unable to contact you or your children's other parent/carer you authorise the following person to direct us regarding the care of your children.



Parent/Carer Agreement

I understand that The Lakes Church will take all reasonable care to ensure the comfort and safety of my children, however all hazards and dangers associated with the program's activities cannot be foreseen or may be beyond the control of the church, its leaders or staff.

In the event of an emergency, I authorise the leaders to obtain medical assistance and I accept responsibility for payment of any associated costs.

I understand that photographs and/or video may be taken during the course of the program and that these images may be used in information about the program in print and online. I will advise the church in writing via if I wish my child to be excluded.



Register additional children  OR  Submit after all children's details have been entered.