Kidz Meet Registration

Mills Park Center Level 01 Brixton Street, Bechenham
Every Sat 5:00 pm to 6:30 pm

Primary Contact details*
First Last
Parents Name
Phone*
Email*
Children attending Kidz Meet in 2022 (Kindy to Year 6)
Child 01
First Name Last name Date of birth School Year Allergies if any

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Emergency Contact (In case primary contact is not available)
Name
First Last
Phone
Empowered Kidz
Would you like to be included in our WhatsApp group for notifications of what is happening at Empowered Kidz and the other ministries of Empowered nations church.
Other ministries
Would you like to be included in our WhatsApp group for notifications of what is happening at Empowered Kidz and the other ministries of Empowered nations church.
Media Waiver*
I acknowledge that Empowered Kidz will be captured in photographs, video and audio. Empowered Kidz reserves all rights to use such material for promotional purposes. I understand that it is a condition of my child participating in Empowered Kidz that all claims are waived in relation to inclusion of their likeness in such films or recordings. I give my consent for my child to be captured on photographic, video and audio media, unless specifically requested in additional notes below.

First Name	Last name	Date of birth	School Year	Allergies if any

Children attending Kidz Meet in 2022 (Kindy to Year 6)