Adventure

CBC Adventure Kids Club

Adventure is a Friday afternoon group for kids from Kindy to year 5.

The program runs between 4pm and 5.30pm with dinner included.

Here at CBC we really value kids. We aim to create a safe, friendly and fun place for them to belong and make friends. This is why all the adults who help out are equipped with a Working with Children Check and Safe Ministry Training. Being Christians, we love Jesus, so amongst the fun there will be brief moments to think about the bigger things in life. Check out the program attached for all the amazing things we have planned for this term.

We are really excited to welcome new kids along and can’t wait to meet your family this Friday at 4pm. See you there.

Starts: Friday 18th October 2019

Times: 4 – 5:30pm DINNER INCLUDED!

Location: CBC – 74 – 76 Captain Cook Dirve Caringbah.

Years: Kindy – Y5

Cost: $5/week

Contact Annie: AHewetson@ecbc.org.au or 0420 312 540

To register, please fill in the form below.

Family Details

SURNAME:

MOTHER'S NAME:

MOTHER'S MOBILE:  

FATHER'S NAME:

FATHER'S MOBILE:  

HOME PHONE:

ADDRESS:

EMAIL ADDRESS: (for weekly updates):

Alternate Emergency Contact

ALTERNATE CONTACT'S NAME:

ALTERNATE CONTACT'S RELATIONSHIP TO CHILD:

ALTERNATE CONTACT'S PHONE NUMBER:

Are there any CUSTODY ISSUES? NOYES. If YES, please discuss with ministry leader.

Child/Children's Details

Child 1

CHILD 1 NAME:

CHILD 1 SEX: MF

CHILD 1 DATE OF BIRTH:

CHILD 1 GRADE:

Child 2

CHILD 2 NAME:

CHILD 2 SEX: MF

CHILD 2 DATE OF BIRTH:

CHILD 2 GRADE:

Child 3

CHILD 3 NAME:

CHILD 3 SEX: MF

CHILD 3 DATE OF BIRTH:

CHILD 3 GRADE:

Child 4

CHILD 4 NAME:

CHILD 4 SEX: MF

CHILD 4 DATE OF BIRTH:

CHILD 4 GRADE:

Child 5

CHILD 5 NAME:

CHILD 5 SEX: MF

CHILD 5 DATE OF BIRTH:

CHILD 5 GRADE:

Medical Information

MEDICARE INFO

MEDICAL CONDITIONS:

MEDICATION:

Please list the following in the field below:

  • Medication Name
  • Dosage
  • Time of Dosage

DIETARY REQUIREMENTS:

Please outline any specific dietary requirements (indicating the relevant child) in the following field below:

ADDITIONAL NEEDS:

Please outline any specific behavioural or learning issues (indicating the relevant child) in the following field below:

Indemnity

I/We

• understand all reasonable safety precautions will be taken at all times by CBC Leaders and staff during events and activities

• authorise any treatment by an accredited hospital and/or physician deemed necessary for the subject of the release in case of an emergency

• understand the possibility of unforeseen hazards and know the inherent possibility of risk

• agree no to hold CBC Leaders, employees, and volunteer staff liable for damages, losses, diseases or injuries incurred by the subject of this form.

Parent/Guardian Signature

Please use your mouse to sign in and if you make a mistake just press clear.

DATE: