Youth Group Enrolment Form • St Lukes Miranda

Please fill in the form for the child attending a Youth Group at St Luke's. Your details as parent or caregiver can be provided under the "Emergency Contact" section.

Emergency Contact Details *

Tip: Name, relationship to child and contact number for the emergency contact

Other Health Notes

Tip: Is there anything that would be helpful for us to know in caring for your child? (Impairments, behavioural issues etc.).

I give permission for photos of my child taken at youth group events to be used on official youth group material unless I advise leaders otherwise *

Yes

In case of medical emergency I herby give permission to the doctor chosen by the church authorities, or other persons supervising or administering the kids activity to secure proper treatment for and/or order hospitalisation or treatment. *

Yes

This information is collected for the purposes of attending Youth Group or Church activities at St Luke's Miranda. Information is stored in our church database system and is not distributed openly. Relevant information, such as contact details, may be distributed to your child's particular year group leaders and their head leader where needed. Once you have submitted this information, you can re-visit this link at any time to update the information as needed. Please contact the church office if you have any questions about how your information will be stored or used.