Kyck Form

KYCK 2018 Registration Form

Personal Info

First Name

Last Name

Date of Birth

Email Address

Mobile Number

Parents Name

Parents Email

School Name

School Grade

Emergency Info

Emergency Contact

Relationship to Child

Emergency phone number

I authorise a leader (with First Aid training) to arrange for my child to receive medical treatment when they deem necessary and if I am unable to be contacted.

KYCK info

Medication

Allergies

I give permission for my child to ride in leaders' cars during the camp (no red P plates)

I understand there will/may be photographs and or video footage of my child taken during this camp to promote the ministry.