WBC Child and Youth Information Form • WBC Connect

Thank you for taking a couple minutes to complete this form and ensure we have up to date information for your child/ren. We ask that this information is resubmitted at the beginning of each year so that we can best care for your child/ren. If you wish to complete this form for siblings, click on the "Please click to add another child" button.

If you have any questions at all, please do not hesitate to contact the program leader.

Thank you!

First Name *

Preferred Name

Last Name *

Date of Birth *

Mobile Number *

Family Email Address

Home Address *

Home City *

Home Postcode *

School attending

School Grade *

Parent/Guardian 1 Name *

Parent/Guardian 1 Mobile number *

Parent/Guardian 2 Name

Parent/Guardian 2 Mobile Number

Medical Information / Conditions

Medications taken and dosage etc.

Behaviour/additional needs

Note: Please only provide your young person's mobile and email if you are happy for leaders to contact your young person directly on occasion with information all with inaccordance to our Safe Spaces policy (Youth Only)

Young Person's Mobile Number

Young persons email address

Emergency Contact Information

Parent/ Legal Guardian is contacted first Please provide an additional person.

Name of Emergency Contact *

Emergency contact number *

Relationship to child (emergency contact)

Accident / Injury

In the event of accident or injury, I give permission for suitably trained leaders to administer first aid if required and understand that I will be notified as soon as possible after the event.

I further authorise the use of ambulance and/or anaesthetic by a qualified medical practitioner if in his/her judgment it is neccesary. I accept responsibility for payment of all expenses associated with such treatment.

Travel (Youth Only)

I understand that for all WBC Youth ministry events hosted offsite, a permission form will be sent to parents. In the absence of a signed permission form, I deem that in bringing my young person to WBC Youth (or its programs and gatherings) I willingly consent to the permission form and all contained disclaimers. I understand that while all duty of care will be taken to supervise my young person, youth leaders will not be liable for any misadventure.

On occasion, offsite activites may require travel by bus or car. Do you give permission for your young person to be driven by WBC Youth ministry leaders and volunteers from Wyong Baptist Church? No red 'P' plate drivers will be allocated to drive youth of any age.

Do you allow your young person to be driven when required

Yes

Photography

On occasion photos or videos may be taken by leaders to capture events. Sometimes these photos may be used in displays, on the church website, on social media profiles or printed for church use. We respect the privacy of all the young people who attend our programs, so if you wish for your child to not be photographed or have further questions around our photography policy please speak with our program leaders at your earliest convenience.

Image Use

Internal Use Not Allowed

External Use Not Allowed

Declaration

I consent to my child becoming a member of the above program(s). I will encourage my child to attend and participate regularly and to cooperate with the leaders and other children.

I agree to indemnify and hold harmless the Baptist Union of NSW, the church and any individual staff or voluntary leaders against all claims arising out of any injury to the child and the relevant activity being undertaken unless such injury results from a failure in the duty of care of the Baptist Union of NSW, the church or any individual staff or voluntary leaders.

Declaration *

By marking this box and submitting this form I declare that I am the parent or legal guardian of the young person/s mentioned above. I declare all information provided is accurate and up to date, and I reaffirm all permissions granted.

Your full name *

Relationship to child

Permission Form Signed Date *