Playcircle Registration

Playcircle Registration - Playcircle 报名表

Child's Details - 孩童资料

Please answer the following questions on behalf of the child. To register more than one child, please press the button 'Add Another Child' at the end of this form to add their details.

First Name - 孩童名字 *

Last Name - 孩童姓氏 *

Date of Birth - 孩童生日 *

Gender - 性别 *

Address - 住户地址 *

Suburb - 地区 *

Post Code - 邮政编码 *

Languages spoken/understood - 沟通语言

Allergies - 过敏

Person who attends Playcircle with the child: 家长/监护人资料

Please answer the following questions for the adult who will attend Playcircle with the child. If there is more than one adult in the family attending Playcircle, please provide their full name and mobile phone number in the comment box below.

Parent/Carer First Name: 家长/监护人名字 *

Parent/Carer Last Name: 家长/监护人姓氏

Parent/Carer's Mobile Number: 家长/监护人手机电话号码 *

Parent/Carer's Email Address 家长/监护人邮件地址 *

Relationship to Child 与孩童的关系 *

Any Comments: 其他资料

Different Contact - for Emergency Use only 紧急状况联络资料（必须和以上的家长/监护人资料不

Please provide the contact details of an adult who does not regularly attend Playcircle with the child, so that we can contact them in the unlikely case of emergency.

Emergency Contact First Name 紧急状况联络人名字 *

Emergency Contact Last Name 紧急状况联络人姓氏 *

Emergency Contact Mobile Number 紧急状况联络人手机电话号码 *

Relationship to Child 与孩童的关系 *

Photo Permission 照相许可

I give the following permission: Photos and Videos may be used with St Paul's Anglican programmes and services and/or advertising purposes. 我给予以下许可：照片和视频可用于圣保罗圣公会的讯息或广告里。 *

Whatsapp 群组

Would you like to join our St Paul's Playcircle WhatsApp group? 请问您想要加入圣保罗圣公会 Playcircle的 Whatsapp 群组吗?

Yes 要

No 不要

The information collected on this form will be used for the purpose of arranging this St Pauls ministry activity. It will be disclosed to St Pauls staff members and will be handled in accordance with our Privacy Policy. By completing this form, you indicate your consent for us to collect, use and disclose the information you have provided above in this manner.