Youth Registration

Youth Registration Form

We're so glad you're with us!

So that we can best care for your child, please add/update your details below.

Thanks!

Personal Contact Details

First Name *

Preferred Name

Last Name *

Gender

Date of Birth

School Grade

School

Allergies

Dietary Requirements

Youth Mobile Number

Tip: We notify parents in all mobile communication with youth

Youth Email Address

Tip: We notify parents of all email communication with youth

Family Mobile

Family Email

Home Address

Home City

Home State

Home Postcode

I consent to my child taking part in the approved children's programs of Holy Trinity Bendigo Anglican Parish.

Yes

I give permission for my child to be photographed or filmed. I understand that the image may be displayed in the church publications, church building, website in accordance with the Diocese guidelines.

Yes

I authorise the leader/s in charge of the childrens ministries where it is impractical to communicate with me, to arrange for my child to receive such medical or surgical treatment as the leader/s may deem necessary at any time during activities.

I further authorise the use of Ambulance and/or anaesthetic by a qualified medical practitioner if in his/her judgement it is necessary. I accept responsibility for payment of all expenses associated with such treatment.

I appreciate that every care will be taken by the leaders and those connected with that group cannot be held responsible for personal injury, loss or theft of property affecting my child.

Parent/Guardian Name (Qualifies as a signature) *

Date *