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CROSSEYED 2026
Registration Form & Permission to Participate
Child's name
*
First name
Last name
Child's date of birth
*
Child's Email
Only include if you are happy for your child to be contacted this way. Emails will also be sent to the Parent/Carer
Child's address
*
Address line 1
Address line 2
City/Suburb
State/Territory
Postcode
School
*
School Year
*
6
7
8
9
10
11
12
Parent/Carer 1 Details
Name
*
Phone
*
Parent/Carer's Email
*
Relationship to child
*
Father
Grandparent
Guardian
Mother
Parent/Carer 2 Details
Name
Phone
Parent/Carer's Email
Relationship to child
Father
Grandparent
Guardian
Mother
Emergency Contact if parent/carer not available
Name
*
Contact number
*
Relationship to child
*
Aunty
Brother
Family Friend
Father
Guardian
Mother
Sister
Stepfather
Stepmother
Uncle
Child's Medical Information
Allergies
*
No Allergies
Yes Asthma
Yes Dairy
Yes Nuts
Yes Other
Yes Peanuts
Yes Seafood
Allergies not listed above
Treatment for allergic reaction
Medical conditions
*
Diabetes
Epilepsy
None
Other
Medical conditions not listed above
Managing the medical condition
How should we manage this medical condition?
Child's Dietary Information
Special Dietary Needs
*
No Dairy
No Nuts
None
Other
Dietary needs if not listed above
Other relevant information
Photo and video permission
Do you give permission for photos or videos of this child to be used in social media posts or on screen at Bayside Community Church. Your child will not be identified by name or school.
*
No
Yes
Virtual Gathering permission
Do you give permission for your child to join virtual gatherings? The gatherings will only open when two(2) Crosseyed leaders are present. A link will be sent to the child's email address if provided above and parent/carer email provided above.
*
No
Yes
Permission to administer First Aid
Do you give permission for the Crosseyed leaders to administer First Aid or call an ambulance if required?
*
No
Yes
Transport in private cars
If you are unable to pick up your child from Crosseyed who are the people you authorise to transport them home?
*
Thank you for providing this important information. The safety and well-being of your child is our primary concern. Please update the Crosseyed leaders if there are any changes to this information. During Crosseyed they will be supervised by the Crosseyed leaders and the program involves games, food and a talk from the Bible. All leaders are screened and trained and have verified Working with Children Checks. By submitting this form you are giving permission for your child to attend the Crosseyed program run by Bayside Community Church
Submit
Please check the highlighted fields
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