Children & Youth Information Form 2019 - DCOC
Please complete the following form for all young people (grades K-12) who will be participating in Children and Youth activities during 2019. Please notify us of any changes throughout the year as soon as possible.

Ignite Kids (Sunday Morning), Boyzone, Girlzone, Ignite Youth Junior High (Grade 6-8) and Ignite Youth Senior High (Grade 9-12).

The following information will help us offer responsible care for your child. Please provide any information that will help leaders ensure the safety of your child. Please notify us of any changes as soon as possible.
  • Student Information

    Please answer the following section with details about the young people attending the youth programs
  • / /
  • Please include details of symptoms and management procedures.
  • / /
  • Please include details of symptoms and management procedures.
  • / /
  • Please include details of symptoms and management procedures.
  • Parent / Guardian Information

  • This email will be used to send electronic copies of programs etc.
  • Please tick as many as you would like
  • Emergency Contact Information

    Please list someone not already listed above.

    For Ignite Kids please lsit the name and contact details of the adult that your child attends church with if they don't come with a parent/carer
  • For Friday Night Programs Only - Boyzone, Girlzone, Ignite Youth (6-8) and (9-12)

  • Please include information about custody arrangements etc. if appropriate
  • Extra Permissions

  • At Youth Events photos or videos may be taken. These media items may be used in sensitive & appropriate ways for promotional material of the church. This includes but is not limited to, brochures, websites, PowerPoint presentations, displays, advertising and other printed/electronic material.
  • Consent Section

    By submitting this form you are consenting to the following:

    I consent to the leaders acquiring for this child medical services necessary in the event of an emergency; and agree to pay all associated medical expenses incurred on behalf of this child.
    I give permission for my child to participate in Children & Youth Group activities that may include but is not limited to: trips around the local area with church approved drivers*, water activities, bonfires, ball sports and others. I understand that by my child attending youth events, consent has been given for them to participate in the activities planned.
    Please note: Certain events will require separate permission forms.
    I understand that my child needs to be signed in and out of events by an adult

    For any issues or questions regarding these policies please contact Iain Anderson on:
    Mobile - 0429694343,
    Church office - 64243441 (Tuesdays & Fridays)
    Email -
  • Contact details for person filling form out

    Please note that this form must be filled out by the student's legal parent/guardian.
Powered byEMF Contact Form
Report Abuse