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Family Registration Form - 2024
Welcome to Kids Club for 2024. It will be great to have your family join us on Friday Nights at Northcote Baptist Church.
INFORMATION:
Term 2: START 3 May – FINISH 21 June
NB: no Kids Club 31 May (King's Birthday Weekend) or 28 June (Matariki Weekend)
Term 3: START 26 July – FINISH 20 September
NB: no Kids Club 16 August (Mid-term Break)*TBC
LOCATION
: Northcote Baptist Church, 67 Eban Avenue, Hillcrest
FEES
(by donation): $5 per child/session**. Payment can be made by online banking or in cash on the night.
** Please discuss with Judyanne if this presents a challenge for your family.
In order for us to provide the best level of care while your child is with us, please fill out the Registration Form below. The information provided will be treated confidentially within our team.
If you have any questions please email: judyanne@nbc.org.nz or call 094807064.
Your Contact Details
Parent or Caregiver's Name
*
First name
Last name
Email
*
Mobile Phone
*
Family Address
Address line 1
Address line 2
Address line 3
Address line 4
Town/Suburb
City
Postcode/Zip
+ Add another parent
- Remove
Your Child's Details
Child's Name
*
First name
Last name
Date of Birth
*
Gender
*
Male
Female
School Year (Yrs 2-6)
*
1
2
3
4
5
6
7
8
9
10
11
12
13
How did you hear about Kids Club?
*
Attended last year
Friend / Family
NBC Newsletter
School Newsletter
Facebook
Other
Any allergies and/or medical information we need to be aware of?
List any special care required (ie: dietary needs, disabilities)
Emergency Contact(s)
*
Please include at least one name and mobile number
Anyone not allowed legal access to your child?
If yes, please enter details here or contact Judyanne. email: judyanne@nbc.org.nz
I give permission for my child's image to be used for Kids Club purposes
*
You are granting permission for your child to appear in photos or video prepared by Kids Club. This permission is for the purpose of sharing information about Kids Club through printed brochures and/or online channels of Northcote Baptist Church.
No
Yes
+ Add another child
- Remove this child
Privacy Statement: Thank you for signing up! The purpose of collecting your information is to keep you up to date with the news and events in regards to Northcote Baptist Church Kids Club. Should we host other events we may also inform you of those as well. If you no longer wish for us to hold your information you may contact us at any time.
Please check the highlighted fields
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