Youth Ministry Registrations
Registration form for Youth Activities (11-17 year olds) at Excel Church.
Which activities would you like to sign your son/daughter up to? *
Required
Forenames of Young person *
Your answer
Surname of Young Person *
Your answer
Sex *
Date of Birth of Young Person *
MM
/
DD
/
YYYY
Young person's Address *
Your answer
Postcode *
Your answer
Young person's School
Your answer
Parent's Email address
This will help to keep you informed about what is going on at Excel Church. We will never pass your information on to any third party.
Your answer
Details of any regular medication, medical problem (eg - asthma, epilepsy, diabetes, allergies, dietary needs etc.) or disability which may affect normal activity
Your answer
GP name and Telephone number
Your answer
Date of last anti-tetanus if known
MM
/
DD
/
YYYY
Parent's Telephone Number *
Your answer
Parent's Email Address
Your answer
Communication Consent
We would love to keep you and your child informed about our children’s and youth activities and other relevant events from Excel Church if you would like to receive this information, please tick this boxes that apply, you can change your preferences or choose to be forgotten at any time by contacting the church office. We will never pass your info on to a third party. We would also love to make it possible for our leaders to communicate with your son/daughter via SMS text and or via social media (where age appropriate) – this way our vetted leaders can get alongside them and help them to navigate this season of life. We encourage group messaging where possible. If you would like to know more about our social media policy (regarding contacting young people on Facebook etc.) please contact the office or see our web site. How can we communicate with you and your son/daughter?
Does you child live with you? If not, who do they live with? *
Please provide NAMES and RELATIONSHIP to the child of any carers.
Your answer
Additional Emergency Contact Number (recommended)
This could be a grandparent or another parent etc.
Your answer
Consent *
I give permission for the above-named child to take part in the normal activities of this group. I understand that separate permission will be sought for certain activities, including swimming, and outings lasting longer than the normal meeting times of the group. I understand that while involved he/she will be under the control and care of the group leader and/or other leaders approved by the church leadership and that, while the staff in charge of the group will take all reasonable care of the young people, they cannot necessarily be held responsible for any loss, damage or injury suffered by my son/daughter during, or as a result of, the activity. I understand that my child will receive medication as instructed. I also understand that if my son or daughter becomes ill, then every effort will be made to inform me. If I am not contactable, then my child will be given medical or dental treatment as considered necessary further to any medical advice being sought. Excel Church has a Health and Safety policy and a Child Protection Policy. All our volunteers have a valid DBS. From time to time we will use photographs or video from our youth activities as promotional material, either via our website/social media or for print. We will not pass any photos or videos onto other organisations. I give permission for photos of my child to be used in this way.
Required
Minibus Consent
(optional for those using the minibus to get to and from Oneighty Youth on Fridays). I give permission for my child named above to use the Oneighty minibus service. I understand that I am responsible for them up until the minibus collects them. For more info about the minibus service, please contact the office.
Your Name *
The name of the parent/carer completing this form
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.