Gateway Church Geelong is required, as per our Child Protection Policy to enroll all children attending programs that will be unaccompanied by an adult. This is to ensure the safety of your child and the safety of other children attending the programs.

The information provided will remain confidential and used only in accordance with our privacy policy.


Child Details


Medical Information

For us to best meet the needs of this child while in our care, please advise us of the following information:


Emergency Contacts

Persons added here have permission to drop-off/pick up your child



I give permission for this child to;

  • Attend programs held by Gateway Church Geelong at Moolap Station Road and to be transported to and from the programs by bus or car accompanied by at least two adults associated with the programs.
  • Go on occasional excursions to public venues.
  • Feature in video footage and have their photo taken at Gateway Church Geelong.  I understand that these photos are for the program’s use only and may be used for promotional material for the program.
  • Be involved in outdoor activities such as bike riding, hiking, sport activities and water activities (swimming).
  • Have sunscreen applied as per Gateway Church Geelong’s Sun Smart Policy.
  • I understand that Gateway Church Geelong is a religious organisation and that the programs may contain religious content and I give permission for my child to attend.

I give consent for medical attention / First Aid to be given to this child. If further attention is required we will do our best to contact you.  If needed, I give permission for an ambulance to be called.

If this child is 13 years or older, I give permission for them to be contacted directly by the leaders of the program through phone calls, text messaging and social media in regards to the program.