CRC Kids Medical Info & Photo Consent Form

Child's Details

Parent / Carer Contact Details

Medical Information

Immunisation Status

If your child has immunisation exemption in place, we will require you to promptly withdraw them from our program should we become aware of any 'communicable disease' to which they have unknowingly been exposed.

Nominated Pick Up Person / Alternative Emergency Contact

This person must be 18+ and be willing and able to provide reasonable care for your child if you cannot be contacted / until you arrive or are able to do so.

Medical Consent

By submitting this form you understand / agree that: I understand that, while full care and attention will be given during activities, I accept full responsibility for my child while he/she is registered at “Kidz Ablaze”. In the event of an injury or illness, I understand that I will be notified as soon as possible. I also give permission for Panadol to be administered by a First Aider in Charge if necessary and also for medical and ambulance services to be called should an emergency arise, and I agree to pay such costs for this, and any other costs incurred due to deliberate damage of property. I release all CRC volunteers from all responsibilities relating to the above matters.

Tip: Please list any instructions if administration of Panadol is deemed necessary - I.e. parent to be contacted prior to any panadol given

Photo Consent