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Erica and Joel
Gordon
Sharayah
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Youth Registration
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Kids Registration
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Induction
Youth Registration
This form is to be completed by the parent or guardian of the teenager attending Berry Youth. (Please fill out one per young person.)
Youth Information
*
Indicates required field
First Name
*
Surname
*
Grade
*
Date Of Birth
*
Gender
*
Male
Female
School
*
Address
*
Suburb
*
Postcode
*
Youth Mobile
*
Parent /Guardian Information
Parent 1 Name
*
Phone number
*
Email
*
Parent 2 Name
*
Email
*
Phone number
*
Medical Information
Emergency Contact
*
Phone Number
*
Medical Insurance Company
*
Policy Number
*
Medicare Number
*
Allergies/Medications
*
Member name
*
Please indicate Y/N
I agree to photographs and videos of activities including my youth to be taken for use within the church community.
*
Yes
No
I agree to photographs and short videos of activities including my Youth to be taken for use within the church community.
I agree to photographs or videos including my youth to be used on social media.
*
Yes
No
I agree to Berry Youth Leaders administering paracetamol if required.
*
Yes
No
I give permission for
Name Of Youth
*
to attend the Youth Ministry at South Coast Life Church. This includes activities, events, outings and other functions.
Name (Parent/Guardian)
*
Date
*
Submit
About us
Purpose & culture
Pastoral team
>
Erica and Joel
Gordon
Sharayah
Affiliation
Policies
News & Events
Next Steps
Community
Connect Groups
Youth
>
Youth Registration
BerryKids
>
Kids Registration
Lets Play
Prayer
Giving
Contact us
Inside SCLC
Induction