Children and Youth Rego February 4, 2021 By G_Taylor REGISTRATION FOR SUNDAY MORNING YOUTH, KIDS CHURCH OR CRECHE BELOW Participant DetailsName (Participant)* First Last Date of birth* Date Format: DD slash MM slash YYYY Program/s attending GP Youth (Friday) Thrive (Friday) Sunday Youth (Sunday) Kids Church (Sunday) Creche under 5's (Sunday) School YearYear 12Year 11Year 10Year 9Year 8Year 7Year 6Year 5Year 4Year 3Year 2Year 1KindergartenCreche (0-5 year old)School Year or equivalent for those home schoolingMedical InformationPlease list any medical conditions or allergies, and any medication or special care they require. If your child is anaphylactic to any substance please provide information regarding EpiPen and management plan.Dietary InformationIs there anything your child can not eat and/or drink? Yes or No? If yes, please indicate foods or beverages your child should not consume.Parent DetailsParent/guardian Name (#1)* First Last Parent 1 Phone*Parent 1 Email* Parent/guardian Name (#2) First Last Parent 2 PhoneParent 2 Email Alternate Emergency Contact PhonePhoto Permissions and Medical EmergencyPHOTO PERMISSIONS (Internal purposes) I permit photos taken of my child to be displayed on notice boards in the church/youth room or other internal purposes.PHOTO PERMISSIONS (External purposes) I permit photos or videos taken of my child to be displayed in church publications, e.g. social media, website, newsletters, brochures, etc.MEDICAL AND LIABILITY RELEASE* In the event of sickness or medical emergency, I request that my child receive any medical attention or treatment deemed necessary, therefore I give permission to any hospital, doctor, and/or health care provider to transport, treat and/or admit for care my child. I understand that I am responsible for all expenses and charges for the treatment and care of my child. In the event that I am not present at the time of the emergency or cannot be contacted, my care has been entrusted to the staff and designated ministry leadership of Green Point Baptist Church.Signature of Parent/Guardian:*Name* First Last