Youth Contact Information Update Form 2023 • St Jude's Anglican Church Bowral

Youth Contact Information Registration

To be completed for all children under 18 years. Effective from Jan 2022 to June 2023.

PRIVACY DECLARATION:
St Jude's is exempt from the requirements of the Privacy Act 1988 (Cth) as it is a "small business". However, we seek to deal carefully with the personal information we collect and to do so in a manner consistent with your reasonable expectations.

The personal information in this form will be made available to:
a) the youth leaders involved in the running of the activities in which your child participates, and
b) medical and emergency services if considered necessary.

Youth contact information

First Name *

Last Name *

Date of Birth *

Email Address *

Mobile Number *

Home Address

Home City

Home State

Home Zip Code

Media Permissions *

School

School Grade

Allergies (Please write Nil if none) *

Medical or other Special Needs (Please write Nil if none) *

Do you give permission for your child to take paracetamol if required?

Permission for youth leaders to contact your child *

Yes

Parent / Guardian Details

Parent / Guardian Full Name *

Parent / Guardian Mobile *

Parent / Guardian Email *

Authorisations

I give permission for my child to attend all scheduled youth activities, unless I advise the youth leaders otherwise.
I authorise the youth leaders, in the event of an emergency, to obtain at my expense any medical, ambulance, rescue or other services that are considered necessary for my child.
I will provide the youth leaders with any information relevant to the wellbeing of my child prior to him or her attending a youth activity.
I can confirm that the information given in this form is true and correct, and will advise the youth leaders of any changes to this information.

Yes

For any further information, please feel free to contact me.
Matt Jacobs
Youth Minister
matt@bowralanglican.org.au