Youth Contact Details • Grace Church Port Macquarie

World Changers Youth - Update details

First time you are attending youth then please fill out below

Personal details

First Name *

Last Name *

Mobile Number

Tip: This number is one where this person can be contacted directly

Email Address

Gender *

Date of Birth *

School *

School Grade *

Medical details

Medical/ allergy conditions

Tip: Please list any medical conditions that would be deemed important for relevant youth leaders to be aware of

Management Plan

Tip: How are these medical conditions managed to prevent or treat if required

Emergency contact details

Emergency contact name *

Relation to youth *

Parents mobile number *

Parents email

Permissions

Photography *

Yes

Tip: Does you give permission for official photos/videos to be published on World Changers Yth owned social media accounts and websites.

Driving *

Yes

Tip: Sometimes our gatherings require driving to a location. Do you give permission to be driven by approved leaders if necessary for youth gatherings.

Liability *

Yes

Tip: Choose 'Yes' if you agree to be responsible for your own actions