Please enable JavaScript in your browser to complete this form.I wish to register my child/ren for: *Creche (Sunday mornings)Children's Church (Sunday mornings)EDAC Play (Wednesday mornings)Kids Club & Junior Youth (Friday evenings)Youth Group (Friday nights)Let us know which program you're registering for and the Team Leader will be in touch soon!Parent/Guardian DetailsParent/Guardian 1 Name *FirstLastDate of Birth *Phone *Email *Relationship to Participant/s *Eg. Mother, grandmother.Parent/Guardian 2 Name *FirstLastPlease list another adult different to Parent/Guardian 1.Date of Birth *Phone *Relationship to Participant/s *Eg. Mother, grandmother.Participant's Address *Address Line 1CityState / Province / RegionPostal CodeParticipant DetailsChild 1 Name *FirstLastDate of Birth *Gender *-MaleFemaleMedicare NumberMedical Impairments, allergies or medicationsPlease list anything specific to your child that will help us better ensure their safety and that of others.Child 2 NameFirstLastDate of BirthGender-MaleFemaleMedicare NumberMedical Impairments, allergies or medicationsPlease list anything specific to your child that will help us better ensure their safety and that of others.Child 3 NameFirstLastDate of Birth Gender -MaleFemaleMedicare NumberMedical Impairments, allergies or medicationsPlease list anything specific to your child that will help us better ensure their safety and that of others.Child 4 NameFirstLastDate of BirthGender-MaleFemaleMedicare NumberMedical Impairments, allergies or medicationsPlease list anything specific to your child that will help us better ensure their safety and that of others.Child 5 NameFirstLastDate of BirthGender-MaleFemaleMedicare NumberMedical impairments, allergies or medications and how to respond or treat themPlease list anything specific to your child that will help us better ensure their safety and that of others.Parent/Guardian AgreementI consent to appropriate use by EDAC of photographs or videos taken that include me and/or my child/ren. *-YesNoEg. inclusion on EDAC's Facebook page, website or flyer.I accept EDAC's Privacy Policy *-YesNoTo view our Privacy Policy, please visit the 'About Us' section of our website. MessageSubmit