Christ Central Youth Permission

Christ Central Youth Emergency Permission

First Name *

Preferred Name

Last Name *

Gender *

Home Address *

Youth email address

Mobile Number (will not be used without permission)

Date of Birth *

School Grade *

Emergency Details

Youth Parent/Guardian 1 *

Youth Parent/Guardian 1 Phone *

Youth Parent/Guardian 2

Youth Parent/Guardian 2 Phone

Youth parent email *

Medical Information

Medical Advice for the Child

Child Medical Note 1 - Critical Issues *

Child Medical Note 2 - Allergies & Intolerances *

Child Medical Note 3 - Other health/behaviour issues *

Privacy Statement

I/we give permission for appropriate photos/videos of my child/ren to be taken at Christ Central Youth events.

I/we give permission for the personal details given herein to be provided to appropriate Christ Central Youth leaders &/or relevant supervisory/medical/emergency services personnel as deemed necessary.

I understand the details given herein will be used by Christ Central Youth leaders to contact myself &/or my child/ren & that the details will not be given to any third party except as provided for above.

Authorisation

I/we hereby give permission for my child/ren to attend Christ Central Youth activities unless I/we explicitly advise otherwise.

In doing so I/we undertake to provide the Christ Central Youth leaders with any information relevant to the wellbeing if my child/ren prior to them attending any & all scheduled Christ Central Youth activities.

We understand that every effort will be made to provide a safe environment for my/our child/ren to participate in. However, in signing this form I/we authorise the leaders, in the event of an emergency, to obtain at my/our expense, any medical, ambulance, rescue or other services considered necessary.

What form of communications & social media do you give approval for contacting your child regarding Youth activities? *

What ministries do you give approval for your child to attend? *

Do you give permission for photos and videos to be taken of your child for our Youth social media and website? *

Yes

Do you give permission for your child to drive with an open licensed driver? *

Yes

I would like to receive important Christ Central Youth email reminders and updates *

I understand that by ticking the box below that this is in place of my written signature and gives my permission and authorisation.

Permission and Authorisation *

Date Permission given *