Mainly Music Registration Form

Mainly Music Registration (Mainly Music注册表)

* required 项为必填项

Child's Name 儿童姓名 *

Child's First Name (名字) and Last Name (姓)

First name

Last name

Ethnicity 族群

Gender 性别

仅在一个圈中打勾

Female 女

Male 男

Date of Birth 出生日期 *

Medical / dietary / special needs 医疗需求或特殊需求 *

Yes 是

No 否

Please detail medical concern here 请将具体的医疗需求或特殊需求列在下面

Is there anything you would like us to know about this child? 关于您的孩子，还有什么事情需要我们了解？

+ Add another

In our family we also have children who don't attend Mainly Music
我们家里还有未参与Mainly Music活动的儿童:

Not yet at school 未上学

At school 已上学

Teenagers 青少年

Parent Information 家长信息

Parent 1 name 父/母姓名 *

Cell phone number of Parent 1 父（母）/第一照看人手机号码 *

Email address for Parent 1 父（母）/第一照看人电子邮箱 *

Home phone number 家庭电话

Home street number and name 家庭住址（街道及门牌号） *

Suburb 所属区域

Postcode 邮政编码

City 城市 *

Parent 2 name

Does parent 2 also live at the above address? 父（母）/第二照看人是否在上述地址居住？

Yes 是

No 否

Cell phone number of Parent 2 第二照看人手机号码

Email address: Parent 2 父（母）/第二照看人电子邮箱

Caregiver Details 照看人信息

Please fill in this section if the child(ren) detailed above will usually attend with someone other than their parents eg Granparent, family friend or paid child-carer
如果儿童随除父母以外的人（如祖父母，家人或者其他照看人）一起参加Mainly Music的活动，请填写相关信息

Caregiver's Name 照看人姓名

Caregiver's cell phone number 照看人手机号码

Caregiver's email address 照看人电子邮箱

Home street number and name 家庭住址（街道及门牌号）

Suburb 所属区域

Postcode 邮政编码

City 城市

Parent/ caregiver agreement 父母/照看人同意

I give permission for photos of my child(ren) taken by the leaders of Avonhead Mainly Music during our session to be used for the purpose of a photo board or promotion within St Christopher's Church or on our closed Avonhead Mainly Music Facebook Group - in a way that doesn't identify the child(ren).

我同意Avonhead Mainly Music项目负责人为我的孩子拍照/拍摄的视频，照片和视频在不指名的情况下被用于St. Christopher教会的宣传或Avonhead Mainly Music Facebook活动页面

I am responsible for notifying the program leaders of any changes in circumstance or contact/ medical details

有任何情况、联系人或医疗需求改变的时候，我有义务告知Avonhead Mainly Music项目负责人