Going Bananas Registration 2025

Using this form you will be able to register one or more children for Going Bananas.

Part A collects information about the child.

Part B collects information about the Parent/Guardian and other contact information.

To register another child click on the button "Register another child" at the bottom right hand side. This will also copy all the information supplied for Part B for the first child.

Going Bananas runs in the second week of the July Holidays, from 9.30am till 12pm. (Please note this slight time change)

For 2025 the dates are Monday 14th July till Friday 18th July.

== PART A ==

Child information

First Name *

Tip: E.g. "Ethel" or "Dong Sung"

Last Name *

Tip: E.g. "Richardson" or "Lee"

Preferred Name

Tip: The name you would like us to use when we email you or speak to you informally. E.g. "Ettie" or "Sung". We will use your Given Name if you leave this blank.

Full Name

Tip: If you like, you can specify your full name. E.g. "Ethel Florence Lindesay Richardson" or "Lee Dong Sung"

Gender *

Date of Birth *

School *

Year Level *

Tip: Prep to Grade 6

Address *

Suburb *

Postcode *

State *

Days Attending

Please let us know the days your child will be attending Going Bananas.

Health information

This information will help leaders look after your child should the need arise. As a parent or guardian it is your responsibility to make sure this information is accurate and kept up to date. For serious conditions you should also speak to the senior leader and make sure the leader understands your expectations.

Additional Needs

Does your child require an aide at school?

Yes

Sometimes

Tip: If so, we will be in contact to discuss.

What are other things about your child's additional needs that would be good for us to know.

Food requirements

This information will be passed on to kitchen staff so they can prepare snacks which are part of the program.

Other info

Additional Information on Child

Tip: Include anything that might be helpful to the leaders that has not been mentioned above.

== PART B ==

Parent / Guardian and other contact information

The first parent listed will receive all communications in regards to the Going Bananas Program.

Parent/Guardian's Name *

Mobile *

Tip: If you do not have a Mobile then please enter your Home Number or 'No Mobile'.

Email Address *

Tip: You will receive a confirmation email to this address. If you do not have an email address please enter "No Email Address".

Address *

Tip: Please record address including Suburb and Postcode or if the same as the address recorded above, write 'AS ABOVE'.

Parent / Guardian's Name 2

Mobile 2

Tip: If you do not have a Mobile then please enter your Home Number or 'No Mobile'.

Email Address 2

Tip: You will receive a confirmation email to this address. If you do not have an email address please enter "No Email Address".

Address 2

Tip: Please record address including Suburb and Postcode or if the same as the address recorded above, write 'AS ABOVE'.

Alternative contact

In case we cannot contact either parent in an emergency, please provide an Alternative Contact who may be a relative or a family friend.

Name *

Relationship to child *

Address

Mobile *

Tip: If you do not have a Mobile then please enter your Home Number or 'No Mobile'.

Legal restrictions regarding collection of child

Tip: Please clearly specify any restrictions that may apply. You should also follow this up with the group leader in person.

How did you hear about Going Bananas?

Are you members of St Alfred's?

Permissions and Consent

Photos or Videos *

Tip: Leaders will take reasonable steps to prevent photos or videos from being taken by people who are not authorised by St Alfred's to do so. Any photo or video used by St Alfred's will comply to the Photo & Video Release Policy.

Photo consent status

No consent

Consent

DO NOT PHOTOGRAPH

Governance

St Alfred's is part of the Melbourne Anglican Diocese and takes seriously it's resposibility to provide a safe place for children and vulnerable people. You can find our Safe Ministry policy here.

Photos or Videos

Leaders will take reasonable steps to prevent photos or videos from being taken by people who are not authorised by St Alfred's to do so. Any photo or video used by St Alfred's will comply to the Photo & Video Release Policy.

Authorisation

I authorise the leaders in charge of any activity conducted by St Alfreds Anglican Church, Blackburn North to consent on my behalf, where it is impractical to communicate with me or my nominated contacts, to receive medical or surgical treatment as may be deemed necessary. I am also responsible for the cost of any such medical treatment deeded necessary.

Indemnification

I agree to indemnify and hold harmless the Anglican Diocese of Melbourne and the church leaders conducting this program against all claims, demands, suits and liability of whatever nature and howsoever arising out of injury to the child and the relevant activity being undertaken.

Personal Information & Privacy

I consent to my personal information being collected according to the St Alfred's Privacy Policy.

Personal information is maintained and managed using the Elvanto web service.

Name of the person filling out the form *

Relation to child of the person filling out the form *

Self

Parent / Guardian

Today's date *

== PART A ==

Child information

Days Attending

Health information

About your health

Medication

Additional Needs

Food requirements

Other info

== PART B ==

Parent / Guardian and other contact information

Alternative contact

Permissions and Consent