ENDURING PERMISSION FORM 2025

To be completed for each child and youth annually

Please select from the programs below: *

Playtime (Playgroup, Tuesday)

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)

Kidzown (Kids Club, Wednesday)

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

Other - specify below

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: *

Current / expected school name: *

Current school year?

Parent/Guardian Details #1

First Name *

Surname *

Relationship to child *

Mobile Number *

Email Address *

Home Phone

Parent/Guardian Details #2 (optional)

First Name

Surname

Relationship to child

Mobile Phone

Emergency Contact Alternative

Alternative Emergency Contact Name and Phone (if parent 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

Privacy Declaration:

I/we give permission for the personal details provided to be given to appropriate supervisory/medical/emergency services personnel and HASPAC leaders 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/ren 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/ren 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/ren. In the event of an emergency, permission is given to obtain at my/our expense, any medical services considered necessary.
I understand that every effort will be made to provide a safe environment however I understand preschool aged children remain the responsibility of their parent or carer whilst onsite whether they are a part of an activity or not.
I/we acknowledge that in the course of HASPAC activities, appropriate photos or videos of my/our child/ren may be taken by authorised personnel and may be used for an internal or external audience as selected above unless i/we explicitly advised 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/ren being sent home and or being temporarily or permanently prohibited from attending a group.

Do you give permission for your child's/children's photo/video to be taken at HASPAC activities and displayed (please select) *

Name and phone number of the child's regular doctor *

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

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 anyone who is legally prohibited from contacting or collecting 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