Children's Ministry Registration (Child) -- 2022 • St Luke's Liverpool

Thank you for registering your child!
Please fill in the form below so that we will have all the details we need to take good care of your child.
This form is to be filled out only by the child's parent/guardian.

Child Details

First Name *

Preferred Name

Middle Name

Last Name *

Sex *

Date of Birth *

School *

School Grade *

Media Permissions *

Yes

Tip: I give permission for photos/videos of my child to be displayed in church

Special Needs *

Yes

Allergies / Medical Conditions *

Tip: If none, write 'none'

Prohibited Persons *

Tip: Is there anyone who is legally restricted from seeing your child? If none, write 'none'

Home Address

Home Address *

Home Address Line 2

Home Suburb *

Home State *

Home Postcode *

Home Country *

Phone Number

Comments

Tip: Do you have any questions, concerns or additional comments for us?

Click 'Register Another Child' to register another child.
Click 'Submit' to go onto the next page to provide us with your parent/guardian details.