Consent form to attend Youth Ministries - 2024 • Warrandyte Community Church

Youth Details

First Name *

Preferred Name

Phone Number *

Last Name *

Date of Birth *

School Grade *

Email Address *

Home Address *

Home City

Parent / Guardian Details

Parent/Guardian Name *

Phone Number *

Email *

Parent/Guardian Name

Phone Number

I consent to my child attending Warrandyte Community Church Youth Ministry activities.

I will encourage my child to cooperate with the Leaders and other youth.

If I am not contactable, I authorise the leader in charge to arrange for my child to receive such first aid, medical or surgical treatment as the leaders may deem necessary at any time during the activities. I further authorise the use of Ambulance and /or aesthetic by a qualified medical practitioner where in his/her judgment it is necessary. I accept responsibility for payment of all expenses associated with such treatment.

I agree to indemnify and hold harmless the Warrandyte Community Church against all claims, demands, suits and liability of whatever nature and howsoever arising out of the injury to the child and the relevant activity being undertaken.

Please give details of a) any person/s not permitted to contact or collect your child while in the care of Warrandyte Community Church and/or b) any court order related to such.

I give permission for my child to be transported to events and external activities in private cars arranged by the leaders (Note: L’s & Red P’s will not be driving the youth).

Parent/Guardian Name *

Parent/Guardian Authorised *

Please check box

Date *

Medical Record Information

Child's Name *

Medicare Number *

Allergies

Current Medications

Other Medical Information

Parent/Guardian Name *

Parent/Guardian Authorised *

Please check box

Date *

Photo & Video Permission Form

I being the parent/guardian for the said child give my consent for my child to be captured in both photography and video for the youth/children’s ministries at Warrandyte Community Church.

Note: Photos or Video may be used for promotional purposes for Warrandyte Community Church.

Child's Name

Parent/Guardian Name

Date *

Parent/Guardian Authorised

Please check box

Privacy Statement

We only collect information where it is necessary to do so to provide a service to you, or where we are required by law to do so. Access to your personal information is restricted to staff and support staff who require information to provide a service to you. Your details are not available to everyone. We will not pass on any of your personal details to any other organisation or third party. For a copy of our Privacy Policy and how your information is handled please visit our website wcc.org.au.