Mainly Music • Bracken Ridge Baptist Church

Please complete details for children who attend mainly music:

Child 1 First Name *

Child 1 Preferred Name (for name tag)

Child 1 Last Name *

Child 1 Date Of Birth *

Child 1 Gender *

Child 2 First Name

Child 2 Preferred Name (for name tag)

Child 2 Last Name

Child 2 Date Of Birth

Child 2 Gender

Child 3 First Name

Child 3 Preferred Name (for name tag)

Child 3 Last Name

Child 3 Date Of Birth

Child 3 Gender

Details about your family (please complete where applicable):

Parent First Name

Parent Preferred Name (for name tag)

Parent Last Name

Parent Address

Parent Email

Parent Phone Number

Caregiver First Name

Caregiver Preferred Name (for name tag)

Caregiver Last Name

Caregiver Address

Caregiver Email

Caregiver Phone Number

Relationship To Child

How did you find out about mainly music?

Please send me information about the activities of Bracken Ridge Baptist Church

Yes

Is there any other information we should be aware of?

(Allergies / Medication / Etc. Please include any dietary requirements for adults and children attending.)

From time to time photos are taken at mainly music to document the fun at our sessions. These are used by the church that runs this mainly music group. The photos might be used on photo boards, on a private Facebook page for this mainly music, or in the promotion of this local mainly music. I agree to photos of our family being used for these purposes.

Do you agree? *

Yes

I understand that during mainly music, parents/carers are expected to remain with and take responsibility for their children. I know that although the organising team will take all reasonable care, there are still risks to manage.

Do you understand? *

Yes

Social media

Photos of families at mainly music cannot be used on any social media site unless they contain only your child or children where you have permission from parents. Please ensure you do not load photos with groups of children or adults where no permission has been granted. Filming or loading entire songs is prohibited. Please limit film footage to your child/ren only and to a short portion of the song. Thank you.

In the event of an emergency, please contact:

First Name *

Last Name *

Phone Number *

This information is being collected for the express purpose of mainly music. The use of your details will also be to advise of upcoming mainly music events, details of the children and family programs being run through this church and mainly music.