Youth Registration

Parent/Carer details and Permissions

Parent/Carer's Full Name *

Phone Number *

Email Address *

Completing this form acknowledges your permission for your child/children listed below to attend the relevant youth programs at St John's (as indicated below). Children will be supervised by their leaders for the duration of the program only.

Your permissions will remain valid until such time as your child finishes attending the youth programs at St John's, or you advise us of any changes.

I give permission for my child to attend the following youth programs at St John's Anglican Asquith, and accept responsibility for their transport to and from these programs.

Logos Youth Group

Clash

Fireplace

In the case of a medical emergency, and I am not available, I hereby give permission to the doctor chosen by the church authorities or other persons supervising or administering the activity, to secure proper treatment for and/or order hospitalisation, injection, anaesthetic or surgery for my child as named. I understand that every effort will be made to contact me prior to instituting such procedures.

Yes

I give permission for photo/video of my child(ren) to be shown within St John's Church (i.e. PowerPoint displays during a service, when we occasionally show things like an annual video)

I give permission for photo/video of my child(ren) to be shown publicly (i.e. on the church website, Logos Facebook Group)

NB. These are both primarily in either group shots or videos (which we make to look back on all the highlights of camps, or at the end of the year as a recap of all the things we’ve done)

Child's details

First Name *

Last Name *

Home Address

Home City

Home Postcode

Date of Birth *

Gender

School Grade

School

Does your child have any special needs? Please include any allergies, medical conditions, disabilities or behavioural issues.

Is anyone legally restricted from seeing this child? If YES, please provide details.