Life Kids New Families • Life Church Townsville

Parent Details

Father's Full Name *

Father's Mobile Number *

Father's Email Address

Mother's Full Name *

Mother's Phone Number *

Mother's Email Address

Child's Details

First Name *

Last Name *

Gender *

Date of Birth *

Promotional Content

Throughout the year, photographs and videos may be taken during our services and events. These images may include children participating in Life Kids programs and activities.

Photo Permissions *

Yes I give permission for photographs and/or videos that include my child to be used by Life Church for promotional purposes, including social media, websites, printed materials, and other church communications.

No I do not give permission for photographs and/or videos that include my child to be used for promotional purposes. Reasonable efforts will be made to exclude my child from any published media.

Allergy Allert

Please select any allergies or intolerances that apply to your child: *

NONE

Lactose Intolerance

Dairy Free

Celiac

Gluten

Peanuts

Tree Nuts

Egg

Soybean

Sesame

Chocolate/Cocoa

Pineapple

Banana

Celery

Mushroom

Crustaceans

Chickpeas

Molluscs (eg. Mussels, oysters, squid)