KIDS INFO FORM PERSONAL INFO * First Name Last Name Age * Aboriginal or Torress Strait Islander Yes No School Grade MEDICAL INFORMATION Relevant Medical Info Allergies Relevant Medication Parent/Guardian Name * First Name Last Name Parent/guardian phone * (###) ### #### Names of people permitted to pick up your child * I give permission for my child to be photographed for the use of social media and burniecitychurch.com * Yes No I give permission for my child to be videoed for use on social media and burniecitychurch.com * Yes No Thank you!
