NorthernLife Youth Ministry Information Form • NorthernLife Baptist Church

Welcome to Switch Youth!

Dear parent/guardian,

Welcome to Switch! We are passionate about providing a fun, welcoming and, above all, safe environment for your child/ren on a Friday night.

We take the physical and emotional safety of your child/ren very seriously. To that end we have implemented rigorous Safe Church processes and policies to ensure everyone is safe at NorthernLife. All of our leaders have been carefully screened and undergone relevant child-safety training. For detailed information on our Safe Church processes and policies, visit our Safe Church page at https://www.northernlife.org.au/ministries/safe-church.

In the interest of keeping your child/ren safe, please fill out the confidential Ministry Information Form below.

Thank you for helping us provide a safe space for your child/ren. Please contact us with any questions or concerns you may have by emailing youth@northernlife.org.au.

Kind regards,

Benjamin Shanks

Youth Pastor, NorthernLife Baptist Church

PARTICIPANT INFORMATION

Participant's First Name

Participant's Date of Birth

Participant's School Grade

Participant's Last Name

Participant's Gender

Participant's School

Dietary issues: Is there anything your child cannot eat and/or drink?

Yes

Please indicate foods or beverages your child should not consume

Medical conditions: Please list any medical conditions or allergies, and any medication of special care they require. If your child is anaphylactic to any substance please provide information regarding EpiPen and management plan

PARENT/GUARDIAN & EMERGENCY CONTACT INFORMATION

Contact 1

Name *

Relationship to child *

Phone number *

Email address *

Contact 2

Name

Relationship to child

Phone number

Email address

PERMISSION & CONSENT

Authorisations

I authorise the leader in charge to arrange for my child to receive such first aid and medical treatment as a trained first aid person may deem necessary

I authorise the use of calling an ambulance in an emergency

I accept responsibility for payment of all expenses associated with such treatment

Please read the following statement and tick the boxes from which you wish to PRECLUDE your child

I DO NOT give permission for my child to participate in activities outside of the normal meeting complex except where they are within reasonable walking distance

I DO NOT give permission for my child to be transported in private cars arranged by the leaders of the group

I DO NOT permit photos of my child to be displayed in church publications, e.g. website, newsletters, brochures, etc.

Transport Authority: If I am unable to collect my child at the finishing time they may be transported home from the program with the following people: