Youth Ministry - 2023 Registration Form • Werribee Baptist Church

YOUTH DETAILS

First Name *

Surname *

Date of Birth *

Gender

School

School Grade *

Email Address

PARENT/GUARDIAN DETAILS

Home Address *

Home City

Home Postcode

Mother/Guardian Details

Name

Mobile

Father/Guardian Details

Name

Mobile

Please provide at least one email address, as this will be our primary means of contact with you.

Email Address

Who is your families preferred Primary Contact (if applicable)?

ABOUT YOUR YOUTH

Please tell us anything you feel we should know about your child; including ... likes/dislikes, learning difficulties, behavioural challenges, pertinent family issues, medical issues, or anything else that will best help us serve your children.

Does your youth speak multiple languages? If so, please advise.

Please advise which language is their first language.

Is your Youth of Aboriginal or Torres Strait Islander origin? *

Yes

Food Allergies

Medical Conditions

If your youth has an official Medical Condition Action Plan. Please email a copy to the Youth Ministry Team.

youth@werribeebaptist.org.au

Medical Conditions Action Plan

IMPORTANT TO NOTE

Privacy Statement

In accordance with the Privacy Policy of The Baptist Union of Victoria any information provided will be used only for the ministry of this church and activities related to this church. The information will not be released to any organisation outside of this church.

Photograph Disclaimer

At times we take photos and/or videos of the youth, which may be used for Church promotional purposes via our website or social media. If you do not consent to this, please note this below.

Your acknowledgement below confirms your consent for your youth's photo to be used.

Yes ... *

I acknowledge I have read and understood the above Important To Note section.

Notes

ELECTRONIC SIGNATURE

I (Enter name of Parent/Gardian)

completed the above form, with the understanding that our youth will be registered as a part of the current years Werribee Baptist Church's Youth Ministry.