St Lucia Bible Church Youth Ministry
Youth Registration and Permission
Youth Details
Youth First Name
*
Youth Last Name
*
Date of Birth
*
Gender
*
Male
Female
School Grade
-- None --
Pre Prep (2yr before)
Pre Prep (1yr before)
Prep
1
2
3
4
5
6
7
8
9
10
11
12
Adult- Uni Student
Adult
School Name
Youth Email
Home Address
*
Phone Number
Parent/Guardian Contact Information
Parent/Guardian First Name:
*
Parent/Guardian Last Name:
*
Parent/Guardian Phone Number:
*
Parent/Guardian Email:
*
Medical Information
Relevant Concerns:
Allergies/dietary requirements
Restriction from any activity
Disability (physical/mental/learning/emotional)
Other
Details of Relevant Concerns
I grant permission, if my young person is in need, for a leader who has a current first aid certificate to provide first aid.
*
Yes
I grant permission for fully licensed youth leaders to drive my young person in vehicles for youth activities.
*
Yes
No
I grant reasonable permission for photographs / video to be taken during youth activities to be used within the church and in promoting the youth ministry.
*
Yes
No
Comments/Other relevant Information:
Submit