Chorister Contact - Secure

Name*

Email for all correspondence*

Chorister Mobile Phone (where applicable)

Age*

Date of Birth*

Year at School in 2019*

School Attending

Do you give Permission for Gondwana Choirs to share contact details within your choir in order to arrange carpools?

Do you give permission for this chorister to catch public transport home unaccompanied?

T Shirt Size*

Aboriginal or TSI

What grade of music theory is your chorister currently studying (Not for Mini Singers)

Language Group (if known)

Emergency Contact Name*

Please provide an additional (non-parent) contact in case of emergency. Parents will be contacted first.

Emergency Contact Phone*

Medicare Number*

Medicare Placement #*

Medicare Expiry Month*

Medicare Expiry Year*

Swimming Permission

Are you Anaphylatic?*

Do you carry an Epipen?

Do you give Gondwana Choirs the right to administer First Aid?*

Do you give Gondwana Choirs permission to administer Panadol?

Immunisations

Please list regular medication and provide brief details, including whether you need assistance to take required medication

Detail any medical conditions, including asthma, epilepsy, diabetes, heart condition, migraines, mobility issues, dyslexia, abdominal/bowl pain, orthopaedic problems, recurrent infections (i.e. ear, nose, throat, urinary tract) or any past operations

List any known allergies? (e.g. Penicillin, amoxil/other antibiotics, medications, food, plants etc.). If you have experienced an anaphylactic reaction, please detail the cause and severity. Email an anaphylaxis management plan to Gondwana Choirs if necessary

Dietary Requirements. Hold "Ctrl" to select more than one option

Provide further dietary details (e.g. no pork, eat fish)

Are there any court orders in place relating to your family?

National Choirs

Indigenous Children's Choir

Indigenous Choirs