KHC 2025 Registration Form • St Marys & St Clair Anglican Church

St Marys and St Clair Anglican Church Kids Holiday Club 2025

Thanks for registering your child for the 2025 Kids Holiday Club at St Marys and St Clair Anglican Church. We look forward to seeing them, having lots of fun, and learning about God together.

Until then, we'd like to remind you of the details of the Club so things are really clear and your child doesn't miss out on anything.

Dates: Monday 14th - Thursday 17th of July, 2025
Time: 9:30am - 3pm (Thursday 9am - 1:30pm)
Location: 54 Coonawarra Dr, St Clair

This year, our theme is Shipwrecked, and we'll be looking at the book of Jonah. We'll be learning about Jonah's journey with God, and how God is merciful and kind to us when we didn't deserve it.

KHC can be fairly high-paced, but not everything will be sports or running around! Even if you're child doesn't enjoy sports or competition, KHC isn't straying from its core combination of music, craft, activities and bible teaching. All activities will also be fully accessible.

Several leaders have training with special needs and neurodiverse children, we'd love to see your kids come along to hear about Jesus and enjoy the week with us. If you have any questions or concerns, and you would like to speak to someone regarding your child's care, contact Evan at evan@smsc.church.

Lunch is BYO (no nuts)! But we do supply fruit and snack food for morning tea.

BBQ on Thursday! Thursday will be a half-day (9am - 1:30pm) with a BBQ for kids and parents alike beginning at 1pm. This is a great time to meet the leaders, look around the site and see what your kids have been up to! The BBQ is free and we cater for most dietary requirements.

If you have any questions about the Kids Holiday Club or any other church events, then please visit our website at https://smsc.church/ or email Evan at evan@smsc.church or our office at office@smsc.church

Thanks, and see you in July!

A Parent or Guardian must fill out this form. If you have any questions feel free to contact St Marys Youth and Kids Minister, Evan Moses (email: evan@smsc.church)

Child's Details

First Name *

Last Name *

Date of Birth *

Gender *

School Grade *

School Attending *

Church Attending

Contact Details

Parent/Guardian's Name *

Home Address *

Home City *

Home State

Home Post Code

Mobile Number *

Email Address *

Emergency Contact Name

Emergency Contact Relation to Child

Emergency Contact Number

Medical Information

Doctor's Name

Doctor's Number

Medicare Number

Medicare Expiry Date

Allergies/Dietary Requirements *

Is your child on any medication, have any serious illness or disability, have a known behavioural issue or is restricted from any activity? If so, please give details.

Other Medical Information

I authorize the leaders to administer paracetamol to my child as per the instructions on the medication. I understand that this authority is a guideline for the administration of a specific dose, and acknowledge the potential side effects and risk of medication for my child. I acknowledge the administration of paracetamol is not covered in first aid training and therefore will not hold leaders responsible for side effects or medical altercations which arise from the administration.

Administering Paracetamol

Are there any access restrictions to your child?

Help us care ensure your child gets the most out of KHC

Tip: Do you have any tips for advice for us as we spend the week with your child? Is there anything else we should be aware of which can help them get comfortable quickly or break down barriers, or things we should avoid doing so we don't make your child upset?

Authority for Photography and Contact

Authority for Photography

I only consent to PRINTED photos which will be used in my child's craft and brought home

I consent to photos or videos being taken, in which my child appears, for use within the program (i.e. videos or presentations involving the previous days activity).

I consent for my child's photo or video to be taken and used for display or advertising only within the church

I consent for photos or videos of my child to be possibly be posted on the ministry's Facebook page and/or the church website and/or used in external advertisement.

Tip: There will be a large component of photography involved, especially for the kids themselves to take photos home in their scrap books; but we want you to feel that your kids are always safe. Please help us partner with you in this by indicating your consent for your child's photography.

Authority for Contact

I would like information about the kids and youth programs at St Marys and St Clair Anglican Church

I would like information about all programs at St Marys and St Clair Anglican Church

Club days!

Kids Holiday Club runs Monday through Thursday, but we know everyone won't be able to make it every day! Please let us know which days your child is coming so we know to expect them!

Which days are you coming?

Monday

Tuesday

Wednesday

Thursday

Bring your own lunch - same as school

Kids Holiday Club will not be providing lunch for it's attendees (but morning tea will be provided). I acknowledge that I will need to provide lunch for my child (as when they are at school). *

I will provide lunch for my child

Thursday BBQ!

On Thursday we're finishing our camp early to have a BBQ together, and you're invited to join us!

Come and meet the leaders, look around the church and see what your kids have been building.

The BBQ begins at 1pm and is free. Please RSVP below!

Alternatively, you'll be able to pick up your child at 1:30pm.

I'll be coming to the BBQ *

Yes

I'll be bringing others with me (who and how many)

Dietary Requirements (we'll be catering for GF and vegetarian)

Optional Donations

Kids Holiday Club is free, but this doesn't mean it's run without cost to the church. If you are able and willing to support your child through Kids Holiday Club and even sponsor others, below is the cost per child per day.

$10 per child per day
$40 per child for the four days

You can donate by cash on the day or by direct debit to the church's account.
Account Name: St Marys & St Clair Anglican Church
BSB: 062 597
Account Number: 10881490
Reference: KHC [Last Name]

Permission

My signature below indicates:

My willingness to permit my child to participate fully in the Kids Holiday Club program at St Marys and St Clair Anglican Church; specifically St Clair Campus (54 Coonawarra Dr, St Clair).
That all the above information is correct and complete at the time of signing
That I give my permission to be sent a follow-up message after the program has concluded
That I give my permission, the case of a medical emergency, to the doctor chosen (either by the church authorities or other persons supervising or administering the activities) to secure proper treatment and/or hospitalisation, injection, anaesthetic or surgery for my child. I understand that every effort will be made to contact me prior to instituting such procedures

Selecting "Yes" below certifies acceptance of all these conditions

Permission Given *

Date Registration Form Completed *

St Marys and St Clair Anglican Church and its approved leaders will treat all the information collected confidentially. This information may be shared with a third party when it concerns the medical health or care of the individuals listed.