Chorister Contact Name*Email for all correspondence* Chorister Mobile Phone (where applicable)Age*Date of Birth*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Year at School in 2019*- None -Not a StudentKinderPrep123456789101112UniversitySchool AttendingDo you give Permission for Gondwana Choirs to share contact details within your choir in order to arrange carpools?- None -YesNoDo you give permission for this chorister to catch public transport home unaccompanied?- None -YesNoT Shirt Size*- None -Child 6Child 8Child 10Child 12Child 14Child 16Women 10Women 12Women 14Women 16Women 18Men SMen MMen LMen XLMen XXLAboriginal or TSI- None -AboriginalTorres Strait IslanderBothNoWhat grade of music theory is your chorister currently studying (Not for Mini Singers)- None -BeginnerGrade 1Grade 2Grade 3I've completed theory requirementsLanguage 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 #*- None -12345678Medicare Expiry Month*- None -010203040506070809101112Medicare Expiry Year*20162017201820192020202120222023202420252026202720282029203020312032203320342035Swimming Permission- None -YesNoAre you Anaphylatic?*- None -Not RelevantYesNoDo you carry an Epipen?- None -Not RelevantYesNoDo you give Gondwana Choirs the right to administer First Aid?*- None -YesNoDo you give Gondwana Choirs permission to administer Panadol?- None -YesNoImmunisations- None -Up to dateNot up to dateI choose not toPlease list regular medication and provide brief details, including whether you need assistance to take required medicationDetail 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 operationsList 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 necessaryDietary Requirements. Hold "Ctrl" to select more than one option- None -Gluten FreeEgg FreeDairy FreeLactose FreeNut FreeVegetarianVeganHalalKosherOtherProvide further dietary details (e.g. no pork, eat fish)Are there any court orders in place relating to your family?NoYesNational ChoirsNational ChoirsIndigenous Children's ChoirIndigenous Choirs