Children & Youth Registration Form

Use this form to give permission for your child to attend our children and youth activities such as Sunday School, TownKids, TownYouth, etc.

Group

Full name of young person

Date of Birth

Address

PARENT / GUARDIAN DETIALS

Name

Address (if different)

Telephone

MEDICAL DETAILS

Regular medication / medical problems / allergies / disabilities

Date of last anti-tetanus injection (if known)

EMERGENCY CONTACT (if parent unavailable)

Name

Address

Telephone

PERMISSIONS

1. I give permission for my child to take part in the normal activities of this group.
Yes No

2. In an emergency and/or if I am not contactable, I am willing for my child to receive necessary hospital or dental treatment including anaesthetic.
Yes No

3. I am willing / not willing for photos of my child taking part in activities to be used in publicity, on the church website, and on related social media.
Willing Not Willing

4. I am willing for this information to be kept on file and used according to the church’s Data Protection Policy.
Yes No

Date

I confirm that all information provided is accurate to the best of my knowledge.