Holiday Club • Dapto Anglican Church

Three Days 0

Illumination Station

Illumination Station, Holiday Club, is on from Wednesday 15th, Thursday 16th and to Friday 17th of July.

Check-in will open at 8:45 am (official program starting at 9 am), and pick-up is at 3 pm.

Morning and afternoon tea provided; we ask that you please BYO lunch. No nut products please.

Each day begins and ends with an all-in session where kids will come together to worship through song, hear from God’s Word, and pray together. Children will also enjoy activity groups, learning new skills and having a lot of fun. These will include sewing (optional for yrs 3-6 only), craft, STEM activities, baking and a site-wide scavenger hunt.

The Family Showcase Evening on Friday, July 17, from 6–8 pm, will celebrate the week, where children will share what they’ve learned and created throughout the program; there will be a free BBQ and family activities.

Child's Information

First Name *

Last Name *

Date of Birth *

Gender *

School Grade *

School Attended *

Dietary Requirements

Yes, my child has Special Dietary Requirements

Dietary Requirements Explained

Medication

Yes, my child requires medication

Medication Explained

Special Needs

Yes, my child has Special Needs

Special Needs Explained

Legal restricted

Yes, certain adults are legally restricted from seeing my child

No.

Legal Restrictions Explained

Parent's Information

Parent 1 Name *

Parent 1 Phone Number *

Email Address *

Parent 2 Name

Parent 2 Phone Number

Family Address

Home Address *

Home City *

Home Postcode *

Emergency Contacts

Emergency Contact 1 *

Tip: In the case a parent of guardian cannot be reached

Emergency Phone 1 *

Indemnity Agreement

Parents/Guardians please read, sign and date the following: My signature below indicates that I give permission for my child to participate fully in all activities associated with the Dapto Anglican Church. In the case of a medical emergency, I give consent to the doctor chosen by the Dapto Anglican Church leaders to provide proper treatment and/or hospitalisation, injection, anaesthetic, or surgery for my child as named. Information may be shared with a third party when it concerns medical health or care. I understand that every effort will be made to contact me prior to instituting such procedures. I give consent for photos and videos to be taken of my child throughout Dapto Anglican Church activities and displayed publically; inclusive of Facebook and the Church website. I also consent to be contacted by Dapto Anglican Church leaders by mail, phone, or any other pre-arranged agreement. Please call the Church Office 4261 1001 for an appointment to discuss any of the above.

I give consent for photos and videos to be taken of my child throughout Dapto Anglican activities and for them to be displayed publicly in print media and on social media. *

Name of Parent Agreeing to Indemnity *

Date *

One Day Wednesday 0

Illumination Station

Illumination Station, Holiday Club, is on from Wednesday 15th, Thursday 16th and to Friday 17th of July.

Check-in will open at 8:45 am (official program starting at 9 am), and pick-up is at 3 pm.

Morning and afternoon tea provided; we ask that you please BYO lunch. No nut products please.

Each day begins and ends with an all-in session where kids will come together to worship through song, hear from God’s Word, and pray together. Children will also enjoy activity groups, learning new skills and having a lot of fun. These will include sewing (optional for yrs 3-6 only), craft, STEM activities, baking and a site-wide scavenger hunt.

The Family Showcase Evening on Friday, July 17, from 6–8 pm, will celebrate the week, where children will share what they’ve learned and created throughout the program; there will be a free BBQ and family activities.

Child's Information

First Name *

Last Name *

Date of Birth *

Gender *

School Grade *

School Attended *

Dietary Requirements

Yes, my child has Special Dietary Requirements

Dietary Requirements Explained

Medication

Yes, my child requires medication

Medication Explained

Special Needs

Yes, my child has Special Needs

Special Needs Explained

Legal restricted

Yes, certain adults are legally restricted from seeing my child

No.

Legal Restrictions Explained

Parent's Information

Parent 1 Name *

Parent 1 Phone Number *

Email Address *

Parent 2 Name

Parent 2 Phone Number

Family Address

Home Address *

Home City *

Home Postcode *

Emergency Contacts

Emergency Contact 1 *

Tip: In the case a parent of guardian cannot be reached

Emergency Phone 1 *

Indemnity Agreement

Parents/Guardians please read, sign and date the following: My signature below indicates that I give permission for my child to participate fully in all activities associated with the Dapto Anglican Church. In the case of a medical emergency, I give consent to the doctor chosen by the Dapto Anglican Church leaders to provide proper treatment and/or hospitalisation, injection, anaesthetic, or surgery for my child as named. Information may be shared with a third party when it concerns medical health or care. I understand that every effort will be made to contact me prior to instituting such procedures. I give consent for photos and videos to be taken of my child throughout Dapto Anglican Church activities and displayed publically; inclusive of Facebook and the Church website. I also consent to be contacted by Dapto Anglican Church leaders by mail, phone, or any other pre-arranged agreement. Please call the Church Office 4261 1001 for an appointment to discuss any of the above.

I give consent for photos and videos to be taken of my child throughout Dapto Anglican activities and for them to be displayed publicly in print media and on social media. *

Name of Parent Agreeing to Indemnity *

Date *

One Day Thursday 0

Illumination Station

Illumination Station, Holiday Club, is on from Wednesday 15th, Thursday 16th and to Friday 17th of July.

Check-in will open at 8:45 am (official program starting at 9 am), and pick-up is at 3 pm.

Morning and afternoon tea provided; we ask that you please BYO lunch. No nut products please.

Each day begins and ends with an all-in session where kids will come together to worship through song, hear from God’s Word, and pray together. Children will also enjoy activity groups, learning new skills and having a lot of fun. These will include sewing (optional for yrs 3-6 only), craft, STEM activities, baking and a site-wide scavenger hunt.

The Family Showcase Evening on Friday, July 17, from 6–8 pm, will celebrate the week, where children will share what they’ve learned and created throughout the program; there will be a free BBQ and family activities.

Child's Information

First Name *

Last Name *

Date of Birth *

Gender *

School Grade *

School Attended *

Dietary Requirements

Yes, my child has Special Dietary Requirements

Dietary Requirements Explained

Medication

Yes, my child requires medication

Medication Explained

Special Needs

Yes, my child has Special Needs

Special Needs Explained

Legal restricted

Yes, certain adults are legally restricted from seeing my child

No.

Legal Restrictions Explained

Parent's Information

Parent 1 Name *

Parent 1 Phone Number *

Email Address *

Parent 2 Name

Parent 2 Phone Number

Family Address

Home Address *

Home City *

Home Postcode *

Emergency Contacts

Emergency Contact 1 *

Tip: In the case a parent of guardian cannot be reached

Emergency Phone 1 *

Indemnity Agreement

Parents/Guardians please read, sign and date the following: My signature below indicates that I give permission for my child to participate fully in all activities associated with the Dapto Anglican Church. In the case of a medical emergency, I give consent to the doctor chosen by the Dapto Anglican Church leaders to provide proper treatment and/or hospitalisation, injection, anaesthetic, or surgery for my child as named. Information may be shared with a third party when it concerns medical health or care. I understand that every effort will be made to contact me prior to instituting such procedures. I give consent for photos and videos to be taken of my child throughout Dapto Anglican Church activities and displayed publically; inclusive of Facebook and the Church website. I also consent to be contacted by Dapto Anglican Church leaders by mail, phone, or any other pre-arranged agreement. Please call the Church Office 4261 1001 for an appointment to discuss any of the above.

I give consent for photos and videos to be taken of my child throughout Dapto Anglican activities and for them to be displayed publicly in print media and on social media. *

Name of Parent Agreeing to Indemnity *

Date *

One Day Friday 0

Illumination Station

Illumination Station, Holiday Club, is on from Wednesday 15th, Thursday 16th and to Friday 17th of July.

Check-in will open at 8:45 am (official program starting at 9 am), and pick-up is at 3 pm.

Morning and afternoon tea provided; we ask that you please BYO lunch. No nut products please.

Each day begins and ends with an all-in session where kids will come together to worship through song, hear from God’s Word, and pray together. Children will also enjoy activity groups, learning new skills and having a lot of fun. These will include sewing (optional for yrs 3-6 only), craft, STEM activities, baking and a site-wide scavenger hunt.

The Family Showcase Evening on Friday, July 17, from 6–8 pm, will celebrate the week, where children will share what they’ve learned and created throughout the program; there will be a free BBQ and family activities.

Child's Information

First Name *

Last Name *

Date of Birth *

Gender *

School Grade *

School Attended *

Dietary Requirements

Yes, my child has Special Dietary Requirements

Dietary Requirements Explained

Medication

Yes, my child requires medication

Medication Explained

Special Needs

Yes, my child has Special Needs

Special Needs Explained

Legal restricted

Yes, certain adults are legally restricted from seeing my child

No.

Legal Restrictions Explained

Parent's Information

Parent 1 Name *

Parent 1 Phone Number *

Email Address *

Parent 2 Name

Parent 2 Phone Number

Family Address

Home Address *

Home City *

Home Postcode *

Emergency Contacts

Emergency Contact 1 *

Tip: In the case a parent of guardian cannot be reached

Emergency Phone 1 *

Indemnity Agreement

Parents/Guardians please read, sign and date the following: My signature below indicates that I give permission for my child to participate fully in all activities associated with the Dapto Anglican Church. In the case of a medical emergency, I give consent to the doctor chosen by the Dapto Anglican Church leaders to provide proper treatment and/or hospitalisation, injection, anaesthetic, or surgery for my child as named. Information may be shared with a third party when it concerns medical health or care. I understand that every effort will be made to contact me prior to instituting such procedures. I give consent for photos and videos to be taken of my child throughout Dapto Anglican Church activities and displayed publically; inclusive of Facebook and the Church website. I also consent to be contacted by Dapto Anglican Church leaders by mail, phone, or any other pre-arranged agreement. Please call the Church Office 4261 1001 for an appointment to discuss any of the above.

I give consent for photos and videos to be taken of my child throughout Dapto Anglican activities and for them to be displayed publicly in print media and on social media. *

Name of Parent Agreeing to Indemnity *

Date *