TCBC Friday Night Youth • Toowoomba Community Baptist Church

PARTICIPANTS DETAILS

Ongoing Leader Communication

Leaders often appreciate the opportunity to be in contact with youth in this ministry. The purpose of ongoing contact is to encourage personal and spiritual growth as well as show them that they matter as a person. Leaders are informed about appropriate levels of communication and accountability. All our our leaders have a bluecard and are trained in child safe standards. Strict rules apply. We have strict policies surrounding this and copies of all communication are stored in our data base. Please contact us at any time for copies of our policy or records.

Ongoing communication permission *

CHILD/PARTICIPANTS INFORMATION

First Name *

Last Name *

Date of Birth *

Gender *

NOTE - If you have given permission for ongoing contact please put in your child's email and/or phone number.

If you have not given permission, please put your email and phone number.

Email Address

Mobile Number

Home Address

Home Address *

Home City *

Home State *

Home Postcode *

Postal Address

Postal Address Same as Home Address

Mailing Address

Mailing City

Mailing State

Mailing Postcode

School Information

School *

School Grade *

PARENT/GUARDIAN DETAILS

Person 1

Relationship to Child *

Tip: Father, Mother, etc.

First Name *

Last Name *

Mobile *

Email Address *

Home Address *

Person 2

Relationship to Child

Tip: Father, Mother, etc.

First Name

Last Name

Mobile

Email Address

Home Address

Medical Information

Medical Cover

MEDICARE DETAILS

Medicare Number *

Medicare Position *

Medicare cards just have MM/YYYY. Please put in the last day of the month it is due so that it matches our DD/MM/YYYY format.

Medicare Expiry *

PRIVATE HEALTH INSURANCE

Do you have Private Medical Insurance

Insurance Provider's Name

Insurance Policy Holder's Name

Insurance Policy Number

EMERGENCY CONTACTS

Other than parents/guardians (just in case primary caregivers are unavailable).

EMERGENCY CONTACT 1

Emergency Contact 1 - Name

Emergency Contact 1 - Number

Emergency Contact 1 - Relationship

EMERGENCY CONTACT 2

Emergency Contact 2 - Name

Emergency Contact 2 - Number

Emergency Contact 2 - Relationship

PERMISSIONS

Other person/s permitted to pick up your child

Other person/s permitted to pick up your child?

MEDIA & PHOTOGRAPHY CONSENT

I give permission for my child/ren to be included in photos or video footage for release to the media, social media and/or use on Toowoomba Community Baptist Church web pages and other publications *

Transport

I/we authorise our child to travel in a car/bus driven by a team authorised leader or parent

Note: It is our practice that leaders/drivers must have a minimum of a P2 licence (green P plate) to transport participating young people. When travelling distances, we endeavour to travel together with the less experienced drivers in the middle of the group.
For accountability, where possible we hold to a 1 to 2 ratio when travelling in cars. I.e. Minimum one leader to two young people, or two leaders to one young person.

Consent to Travel with Youth Leader *

OTHER COMMENTS OR INFORMATION

Are there any other comments you would like to add?

Other Relevant Information

YOUR AGREEMENT WITH US AS THE PARENT/GUARDIAN OF THIS CHILD

By submitting this registration for your child, I understand that each week when I check in my child/ren, they will be under the care of the TCBC YOUTH GROUP leaders when they enter Toowoomba Community Baptist Church. They will be under their care until I have checked out my child/ren at the end of the session.

In attending the program, I am consenting to my child/ren participating in a range of general sporting and recreational activities.

In the unlikely event that medical treatment is required I authorize the leader in charge of the above-mentioned group to arrange for my child/ren to receive such first aid, medical or surgical treatment as the leader may deem necessary at any time during the activities of TCBC YOUTH GROUP. I further authorize the use of Ambulance and/or anaesthetic by a qualified medical practitioner if in his/her judgment it is necessary. I accept responsibility for payment of all expenses associated with such treatment. I accept personal responsibility of making sure that my child/ren has access to any specific medication if required (e.g. asthma puffer, EpiPen).

I consent to my child/ren being taught from the Bible and understand that all conversations will be respectful.

I agree to indemnify and hold harmless Toowoomba Community Baptist Church against all claims, demands, suits and liability of whatever nature and howsoever arising out of the injury to the child/ren, and the relevant activity being undertaken. In return Toowoomba Community Baptist Church will make every effort to ensure a safe environment for all participants.

I recognise that being part of a community involves mutual care and consideration and therefore agree that unacceptable behaviour may result in my child/ren being temporarily/permanently removed from the childrens activities and returned to me.

CONSENT *

Name *

Submission Date *