Children and Youth Information Form 2024

Please complete the following form for all young people Grades K-12 and pre-school who will be participating in Children, Youth, Sunday morning Creche and MOPs activities during 2024.

The following information will help us offer responsible care for your child. Please provide any information that will help leaders ensure the safety of your child. Please notify us of any changes as soon as possible.

Parent/Guardian Information

Parent/ Guardian Names

Mailing Address *

Mailing Address Line 2

Mailing City *

Mailing Postcode *

Main Contact Number *

2nd Contact Number

Email Address

How would you like to be contacted regarding program information? *

Post

SMS

Emergency Contact Information - Please list someone not listed above

For Ignite Kids please list the name and contact details of the adult that your child attends church with if they don’t come with a parent/carer

Emergency Contact Name: *

Relationship to Child / Young Person *

Primary Contact Number *

Secondary Contact Number

Please attach any other information you would like us to know, to help care for you child(ren).

Extra Permissions (Not compulsory and only valid if ticked)

At Children & Youth Events photos or videos may be taken. These media items may be used in sensitive & appropriate ways for promotional material of the church. This includes but is not limited to, brochures, websites, PowerPoint presentations, displays, advertising and other printed/electronic material.

Photo Permission

I DO give permission

I DO NOT give permission

I give permission for my child to be drive by Church approved "P-Plate" drivers for youth activities

Yes

I allow my child to be their own signatory for sign in/out (Grade 11+ Only)

Yes

Consents

By submitting this form you are consenting to the following:

I consent to the leaders acquiring for this child medical services necessary in the event of an emergency; and agree to pay all associated medical expenses incurred on behalf of this child.

I give permission for my child to participate in Children & Youth Group activities that may include but is not limited to: trips around the local area with church approved drivers*, water activities, bonfires, ball sports and others. I understand that by my child attending youth events, consent has been given for them to participate in the activities planned.
Please note: Certain events will require separate permission forms.

I understand that my child needs to be signed in and out of events by an adult

For any issues or questions regarding these policies please contact James Kennedy on:
Church office - 64243441
Email - james@devonportcoc.com.au

Please note that this form must be filled out by the student's legal parent/guardian.

Name of person who completed this form *

Phone number of person completing this form *