Consent to collect sensitive information
By completing this form, you consent to UPBC collecting sensitive information about your child (including medical information, allergies, action plans, medications, and family arrangements) so that we can care for them safely during Kids Quest programs and respond appropriately in an emergency.

Photo & Video Permission
UPBC occasionally takes photos or video during Kids Quest for internal communication, celebration, and church‑community purposes. You may withdraw consent at any time by contacting the Church Office.

We will ensure all appropriate care is taken. If an emergency were to arise, we will make every effort to contact you or your emergency contacts, before enacting our response.

Emergency Disclosure Notice
In the event of illness or injury, UPBC may share relevant medical information with emergency services (ambulance officers, paramedics, medical staff) to ensure your child receives appropriate care.

• Any action plans will need to be reviewed on a yearly basis with the family doctor
• Where an action plan requires the use of an EPIPEN, no leaders or helpers are required by the Church to administer it. In the event of an emergency, leaders will need to obtain the child's parent/s.

I give my permission as the registered child's caregiver for my child to participate in any Children's Ministry/Youth activities run by Unley Park Baptist Church Inc. and acknowledge that the risk of injuries is inherent in physical activities. While I am aware that leaders will take all due care, I recognise that accidents may occur.

If my child becomes ill or accidentally injured, I understand that those representing Unley Park Baptist Church Inc. will follow the instructions given above, administer first aid as necessary and contact Ambulance Services in an emergency.

If any details provided in this form change (e.g., medical condition, custody arrangements, emergency contacts), I agree to notify the church as soon as possible so care can be adjusted appropriately.

The action of submitting this completed form electronically takes the place of a signature. This sufficiently satisfies the electronic signature provisions set out in section 10 of the Electronic Transactions Act 1999 (ETA)