Loading
Immanuel Youth Attendee Rego (part 1)
This form is intended to be filled primarily by a parent or guardian of a child attending a youth ministry run by Immanuel Lutheran Church. There is a section titled 'Child's Commitment' that requires the direct input of the attendee. On the next page we will also ask for the contact details of a parent or guardian.
Attendee Name
*
First name
Last name
Date of Birth
*
Gender
Male
Female
School
School Year
*
1
2
3
4
5
6
7
8
9
10
11
12
13
Attendee's mobile phone
Occasionally used for txt reminders of upcoming events.
Attendee's email address
Sometimes used for reminders of upcoming events, particularly camps.
Allergies
Please include food related and non-food related allergies.
Other Important Information
You can include any other information about your child that would help things go smoothly. This could include managed medical conditions, disabilities, or unsafe relatives/adults.
Child's Commitment
I will respect people and help everyone have a good, safe, fun time.
*
I understand that Immanuel's youth ministries are drug and alcohol free.
*
If I am disrespectful or make people feel unsafe then I may not be allowed to participate in activities, and my parents may asked to take me home.
*
Parent/Guardian Consent
I consent to this information being stored by Immanuel Lutheran Church. It will be used only for youth ministry in accordance with the LCAQD Privacy Policy.
No
Yes
I agree that in the event of a medical emergency where I cannot be contacted, team members will arrange medical care. I agree to pay for all medical costs involved. I will not hold liable Immanuel Lutheran Church or its agents for any injuries incurred.
No
Yes
I consent to the use of photos of my child for promotional purposes within Immanuel College or Immanuel Church.
No
Yes
I consent to my child being transported by car driven a fully licensed team member.
Used for planned excursions during events, such as a beach trip during a camp.
No
Yes
On the next page we will also ask for the contact details of a Parent or Guardian.
Please check the highlighted fields
✔
✘