St Matt's Youth & Kids Registration
Please be assured, your privacy is important to us. The information we seek allows us to better care for your child, manage risks and communicate clearly with you. We are careful to keep your information confidential, and provide it only to those acting on behalf of St Matt's Youth & Kids who need it to fulfil their role (e.g. First Aid officer). We will not use your information for other purposes. Please contact us with any further queries.
Your child's details
Given (First) Name *
of your child. Enter your own name in the 'Parent / Guardian' section.
Your answer
Preferred Name
of your child if different to their Given Name (otherwise leave blank).
Your answer
Surname *
Your answer
Gender *
Date of Birth *
Don't forget to include the year they were born, not this year!
MM
/
DD
/
YYYY
Mobile
Your high-schooler's number if applicable. Enter your own mobile number in the 'Parent / Guardian' section below.
Your answer
Email
Your high-schooler's email address if applicable. Enter your own email in the 'Parent / Guardian' section below.
Your answer
School *
For 2019. If not on this list, please choose 'Other' and we'll email you to get the school name, then add it in for next time).
Grade *
Crèche - school year in 2019.
Dietary restrictions / Food allergies *
Required question. If none write 'Nil'
Your answer
Medical Notes *
Required question. If none write 'Nil'
Your answer
Any comments or other details that leaders should know?
Your answer
Family information
Street Address *
Your answer
Suburb *
Your answer
Postcode *
Your answer
Home Phone Number
If applicable, no spaces.
Your answer
Congregation
Leave blank if your family does not attend church.
Parent/Guardian 1
Parent/Guardian 1 Name *
Your answer
Parent/Guardian 1 Contact Number *
No spaces.
Your answer
Parent/Guardian 1 Email
To receive parent information emails.
Your answer
Parent/Guardian 2
If applicable
Parent/Guardian 2 Name
Your answer
Parent/Guardian 2 Contact Number
No spaces.
Your answer
Parent/Guardian 2 Email
To receive parent information emails.
Your answer
Permissions
Can your teen leave at the end of Youth Group without an adult? *
For Youth Group kids only. If you do not answer 'Yes' someone will have to come into the building to collect them at the end of each night.
May your child cross the road (in the presence of adults)? *
For St Matt's Kids only. If you do not answer 'Yes' they may not be able to join in our activities.
Parent / Guardian Consent
I give consent to my child attending St Matthew's Youth & Kid's programs and commit to encouraging my child to participate fully when attending and cooperate with the leaders and other children. I understand that from time to time activities are held outside the grounds of St Matthew's Anglican Church.

I am aware, in submitting this document for my child’s participation, that certain elements of the programs could be physically and emotionally demanding. Furthermore, I understand that certain inherent risks and dangers may exist in the activities in which my child will be participating. I acknowledge that while the organisation and its leaders will make every reasonable effort to minimise exposure to known risks, all hazards and dangers associated with these activities cannot be foreseen or may be beyond the control of St Matt's staff and leaders.

In the event of any emergency where my nominated contact people are unable to be contacted:
1. I authorise the leaders to obtain medical advice and/or assistance which they deem necessary.
2. I further authorise qualified practitioners to administer anaesthetic if required.
3. I accept all operation, blood transfusion and/or anaesthetic risks involved in the event that such procedures are deemed necessary.
4. I accept the responsibility for payment and agree to pay medical, transport and any other related expenses.

I understand that my child may be photographed as part of group activities, but St Matthew's Youth and Kids will request permission from me before using any individual photograph of my child in print or online.

I confirm that the information contained in this application is true and correct and I agree to inform the leader of any change to these details.

For any queries please contact the church on 9381 2640.
Your Name *
Type your full name to give your consent.
Your answer
Submit
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