Youth Ministry Rego • St John's Maroubra

Roast Youth Ministry Registration

Welcome! Thanks for registering your Youth. This registration is used for all our Youth Ministry events and programs run by St John's Maroubra (e.g., Roast on Friday night).

If you have multiple children attending, enter the details for your first child, then press the 'Add Another Youth' button below.

Thank you for providing this important information. The safety and well-being of the youth is our primary concern. All personal information collected will be used for the purpose of contacting carers in the event of an accident/emergency, supplying appropriate medical care for your child if the need arises, and to inform you of future youth activities that are authorised or approved by St John's Maroubra Anglican Church.

Youth Details

Youth's First Name *

Youth's Last Name *

Email Address

Tip: Used for communication about upcoming events, etc.

Mobile Number

Tip: Best mobile number used for event information.

Gender *

Date of Birth

Address

Suburb

Postcode

School Grade *

School Name

Does your child have any allergies? If YES, please provide details of allergies in the next box. *

Yes (has allergies)

No known allergies

Details of allergies:

Tip: Leave blank if N/A. If relevant, please send action plan to office@stjohnsmaroubra.com

Is there anything that would be helpful for us to know in caring for your child (medical conditions, impairments, behavioural concerns, prescription medication, chronic illness, special diets etc). *

Please provide details of care/medical needs:

Tip: Leave blank if N/A

Parent / Caregiver 1

Full Name *

Mobile *

Email *

Parent / Caregiver 2

Full Name

Mobile

Alternate Emergency Contact

This must be different to the Parents/Guardians provided above e.g. grandparent, neighbour or family friend.

Emergency Contact - Full Name *

Emergency Contact - Mobile *

Emergency Contact - Relationship to Child *

Permission

I give permission for my child to participate fully in activities run by St John's Maroubra Anglican Church. *

Acknowledged

Is there any legal restriction on who can see or pick up your child? *

Yes

If yes, please provide details of legal restrictions:

Tip: Leave blank if N/A

I give permission to the St John's ministry leaders, in the event of an emergency, to provide appropriate medical treatment or to obtain at my expense any medical, ambulance, rescue or other services that are considered necessary for my child. *

Acknowledged

Do you give permission for photos/videos of your child taken at St John's events to be displayed publicly (online and/or in print). *

Yes