ENDURING PERMISSION FORM 2025

To be completed for each child and youth annually

Please scroll to select from the programs below (choose as many as applicable to one child) *

Playtime - Playgroup, Tuesday - Preschool age

Kidzown Kids Club- Wednesday - School grades 2-6

Fresh Youth - Youth Group, Friday - School grades 6-12

Little Sheep - Kids Church, Sunday 10am - not yet at school

Big Sheep - Kids Church, Sunday 10am - School grades K-2

Servos - Kids Church, Sunday 10am - School grades 3-6

Other - specify below

Tip: For Example, if your 10 year old son attends Kidzown and Big Sheep, tick both.

Other program or event not listed above:

Child #1 details (option to add siblings below)

First Name *

Last Name *

Mailing Address *

Mailing City *

Gender *

I give permission for my high school aged child to provide their phone number in order for HASPAC leaders to contact them for logistical or activity purposes only as outlined in our social contact policy (view here https://docs.google.com/document/d/1Pnv)

High Schooler Phone Number

Date of Birth *

Age: *

School name:

Current school year?

Parent/Guardian Details #1

First Name *

Surname *

Relationship to child *

Mobile Number *

Email Address *

Home Phone

Emergency Contact Alternative

Alternative Emergency Contact Name and Phone if above cant be reached *

Privacy Declaration

I/we give permission for the personal details provided here to be given to appropriate supervisory/medical/emergency service personnel or HASPAC leaders as deemed necessary to care for my child. *

I understand that all preschool aged children are the responsibility of their parent / carer whilst they are on site whether they are part of an activity or not. *

AUTHORISATIONS

Declaration:

I/we give permission for the personal details provided to be given to appropriate supervisory/medical/emergency services personnel and HASPAC leaders as deemed necessary.
I understand the details given here will be used solely by HASPAC to care for my child and not given to any unnecessary third party.

Authorisations & Expectations

By completing this form, I/we hereby give permission for my child/children to attend all scheduled HASPAC activities, unless I/we explicitly advise the HASPAC leadership team otherwise.
I/we undertake to provide the HASPAC leaders with any new information relevant to the wellbeing of my child/children prior to them attending any & all scheduled HASPAC activities.
I/we understand that every effort will be made to provide a safe environment for my/our child/children. In the event of an emergency, permission is given to obtain at my/our expense, any medical services considered necessary.
I/we acknowledge that during HASPAC activities, appropriate photos or videos of my/our child/children may be taken by authorised personnel and may be used for an internal or external audience as outlined below unless i/we explicitly advise otherwise.
I/we acknowledge that being part of a community involves mutual care and consideration of others and therefore agree that unacceptable behaviour may result in my/our child/children being sent home and or being temporarily or permanently prohibited from attending a group.
No Alcohol, drugs or weapons are permitted onsite at anytime. Any such items will be removed and we reserve the right to call authorities if deemed necessary.

Please tick

I agree

Do you give permission for your child's/children's photo and/ or video to be taken during their involvement in HASPAC activities. These images and videos may be used for HASPAC internal or external audiences, social media, website and during Sunday Service Live streaming on Youtube. *

Name and phone number of the child's regular doctor (this is because you are leaving your child in our care) *

Equilibrium Healthcare, Walker Street, Helensburgh - 4294 1955

Parkes Street General Practice, Parkes Street, Helensburgh - 4294 1400

Other

Name of Doctor and Phone Number *

Does your child have any medical conditions that we should know about? *

Is the medical condition life threatening or require urgent medical attention *

Please describe the medical condition *

If prescribed by my childs doctor, my child will always have in their possession their epipen or asthma inhaler and a leader will be advised.

Does your child have any special dietary needs that we should know about? *

Please describe

Does your child have any court ordered care or custody arrangements that we should be aware of? *

Please describe *

Please list the name/s of the people who ARE AUTHORISED to collect or contact your child.

Is there anything else we should know that will help us to care for your child/ren, that is not already specified above?

Parent/Guardian Name: *

Parent/Guardian acceptance: *

I agree to the terms and conditions outlined above