LMAP Junior Jivers • Lower Mountains Anglican Parish

LMAP Junior Jivers Registration Form

Fridays 9:30 11:30 am at LMAP Blaxland (16 Taringha St)

A Christian-focused preschool program for children aged 0-6 yrs old, together with their carers. It is music-based, incorporating movement, gross motor skills, percussion, rhymes, story time and craft. The morning culminates with morning tea for adults and free play for the children. Please bring a snack and drink for your child. Gold coin donation.

To add more than one child, first, fill in this form for the first child then click the "Add Another Child" button at the bottom of the form.

If you have any questions or need assistance, please contact the LMAP office at admin@lmap.org.au or (02) 4739 1316.

Child Details

First Name *

Last Name *

Date of Birth *

Gender *

Parent/Caregiver 1 Details

First Name *

Last Name *

Phone Number *

Email Address *

Home Address *

Suburb *

Postcode *

Parent/Caregiver 2 Details

Only include details that differ from Parent/Caregiver 1.

First Name

Last Name

Phone Number

Email Address

Home Address

Suburb

Postcode

Emergency Contact

First Name *

Relationship to Child/ren *

Last Name *

Phone Number *

Dietary Issues

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

Food allergies e.g. nuts (Provide details below)

Other (Provide details below)

Diet Details *

Please provide further details as required:

Details:

Privacy Declaration

The Lower Mountains Anglican Parish is exempt from the requirements of the Privacy Act 1988 (Cth) as it is a small business. However, we seek to deal carefully with the personal information we collect and to do so in a manner consistent with your reasonable expectations.

By submitting this form you acknowledge that the personal information in this form will be made available to:

(a) the LMAP Junior Jivers leaders involved in the running of the activities in which my child participates,

(b) Lower Mountains Anglican Parish's Staff, and

Authorisations & Expectations

I give permission for my child to attend all scheduled LMAP Junior Jivers activities, unless I advise the LMAP Junior Jivers' leaders otherwise.
I authorise the LMAP Junior Jivers' leaders, in the event of an emergency, to obtain at my expense any medical, ambulance, rescue or other services that are considered necessary for my child.
I acknowledge that being part of a community involves mutual care and consideration, and therefore agree that unacceptable behaviour may result in me and my child being sent home and being temporarily or permanently prohibited from attending the activities of LMAP Junior Jivers.
I will provide the LMAP Junior Jivers' leaders with any information relevant to the well-being of my child prior to him or her attending an LMAP Junior Jivers activity. This might include supporting documentation (eg: AVO, Family Court Order) if there is anyone who is legally restricted from seeing your child.
I give permission for photos/videos of my child taken at LMAP Junior Jivers events to be displayed publicly (online and in print) unless I advise the LMAP Junior Jivers' leaders otherwise.
I give permission for any online video meetings run by LMAP Junior Jivers to be recorded for internal compliance purposes.
I confirm that the information given in this form is true and correct, and will advise LMAP Junior Jivers of any changes to this information.

LMAP Junior Jivers Registration Form

Child Details

Parent/Caregiver 1 Details

Parent/Caregiver 2 Details

Emergency Contact

Medical and Care Needs

Dietary Issues

Please provide further details as required:

Privacy Declaration

Authorisations & Expectations