Deeper Youth 2021 registration form

This form is for any family who does not regularly attend Encounter Baptist Church, and would like their young person(s) under the age of 18 to participate in our Deeper Youth program.  

We have this form because we are committed to the safety of your young person and it forms part of our Safe Church processes.  

 

Parents and Guardians Details

Names:

Address:

Phone:

Email:

Emergency Contact: 

Name:

Contact Number:

Young person's Details:

First young person:
Name:

D.O.B


Health/Allergies
Any other information (behavioural or family concerns, specific requests)


Second young person:
Name:

D.O.B


Health/Allergies

Any other information (behavioural or family concerns, specific requests)


Third young person:
Name:

D.O.B


Health/Allergies

Any other information (behavioural or family concerns, specific requests)


*If your young person(s) has a health/allergy conditions requiring a management plan or emergency medication, this must be with the child when they attend  the program or they may be refused admission. 


Parent/Guardian Consent:

I/we give consent to my young person attending the relevant Encounter Baptist Church's Deeper Youth prograam and commit to encouraging my young person to co-operate with the leaders and other participants. 

I/we consent for the leader in charge to arrange medical services necessary in the event of an emergency; and agree to pay all associated medical expenses incurred on behalf of this young person(s). I agree to indemnify and hold harmless the Baptist Union of Victoria and Encounter Baptist Church Inc. against all claims, demands, suits and liability of whatever nature and howsoever arising out of the injury to the child, and the relevant activity being undertaken.

I/we will be happy to receive information relating to events and activities for young people organised by Encounter Baptist Church activities using the email address listed on this form. 

By clicking the "Send" button on this form I/we consent to these conditions during the 2021 calendar year.