Children’s Enrolment Form

FOR PARTICIPANTS UNDER 18 YEARS OLD

Must be completed by a parent or guardian for all participants under 18 years of age with their enrolment.

PARENT/GUARDIAN RESPONSIBILITY

When classes are delivered at Mernda Community House complete the Parent/Guardian Sign-in-Sheet at the beginning and end of each activity session. Let the tutor know if someone else is going to pick up your child. Ensure that your emergency contact details are kept up to date. Ensure that your child understands that they are required to behave in a safe manner and follow all the tutor instructions.

ALLERGIES

We are unable to provide an allergy-free environment and may not accept enrolments in the activity if it is deemed unsafe for your child to participate. We will contact you if your child becomes ill. We reserve the right to contact an ambulance if we believe your child’s safety is at risk with the cost of the ambulance being attributed to you as parent/guardian. We will ensure your child is supervised until your arrival.

Mernda Community House collects and holds all details in accordance with information and privacy laws. Mernda Community House is committed to the safety and wellbeing of children and young people. We recognise the importance and responsibility for ensuring a safe and supportive environment that respects the rights of children and young people, enabling them to thrive.

Participant Details
Name
Gender
Please use format Day/Month/Year
Parent/Guardian/Carer Details
Name (Parent/Guardian/Carer)
Emergency Contact Details
Name (Emergency)
Consent
I authorise the person in charge of the excursion to consent, where it is impracticable to communicate with me, to the child receiving such medical or surgical treatment as may be necessary should the situation arise.
Privacy Statement
I give permission to take and use photos/film of my child/children for promotional use which may include social media.
Medical and Further Info
Are there any legal access restrictions for this child?
If yes, please email a copy to pchristou@whittleseacc.org.au
As the legal parent/guardian for the above child, I agree to the above activity requirements and give consent for them to participate in the nominated course or activity.

For any questions or further information please contact us and we’ll be happy to help!