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)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 medicationsPlease 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