2018 Reboot Registration
Thanks for your interest in Reboot Youth at St Anne's Anglican Church Ryde! Please fill out this form to register your child for this group for 2018.

Fridays 7-9pm
Sundays 10am - 11.30am

This form is to be filled out by Parent or Carer of the youth.

Email address *
Regularly attending:
PARENT/CARER INFORMATION
Relationship to child *
Your answer
Mobile phone number *
Your answer
Home phone number
Your answer
Email address *
Your answer
Home Address *
Your answer
Is there anyone who is legally restricted from seeing your child / children? *
Your answer
YOUTH #1 INFORMATION
First name *
Your answer
Last name *
Your answer
Email *
Your answer
Mobile number (for basic Reboot-related communication)
Your answer
Birth date *
Your answer
School attending in 2018 *
Your answer
School year/grade in 2018 *
Your answer
Any medical / allergies / behavioural issues? *
Your answer
YOUTH #2 INFORMATION
First name
Your answer
Last name
Your answer
Email
Your answer
Mobile number (for basic Reboot-related communication)
Your answer
Birth date
Your answer
School attending in 2018
Your answer
School year/grade in 2018
Your answer
Any medical / allergies / behavioural issues?
Your answer
EMERGENCY CONTACT
MUST be different from parent
Full Name *
Your answer
Contact phone number *
Your answer
Relationship to child *
Your answer
Privacy declaration
St Anne's Ryde Anglican Church respects your privacy. When you provide us with personal information by participating in church events/activities, visiting a website or otherwise, you agree to personal information about you and your children (under 18 years old) being handled as set out in the policy (available on our website). The personal information in this form will be made available to the Reboot Youth leaders, and medical and emergency services if considered necessary.
Authorisations and expectations
By accepting these conditions and submitting this form I permit my child to participate fully in activities associated with Reboot Youth from the 1st January 2018 - 31st December 2018 at St Anne's Ryde Anglican Church.

In a medical emergency, I give my permission for a doctor chosen by a St Anne's Ryde Anglican leader to secure proper treatment for and/or order hospitalisation, injection, anaesthetic or surgery for my child as named. I understand that every effort will be made to contact me prior to instituting such procedures.

I also acknowledge and agree that any photographs or video of my child taken while participating in Reboot Youth may be used by the church to promote future youth activities (i.e. during a church service, on church premises).

I understand that any youth attending Reboot must dropped off and picked up weekly by a parent/authorised adult. I agree to notify the Reboot leaders if the youth will be making their own way to and/or from Reboot.

I confirm that the information given in this form is correct, and will advise any changes to this information to Katie Bolton: 0418 473 263 or katie@stannes.org.au

Acceptance of conditions *
Required
Your name *
Your answer
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