Lifegate Youth Registration 2020 • Lifegate Church

Lifegate Youth Registration Form

Lifegate Youth takes place every Friday during the school term from 7-9 pm.

Lifegate Youth is for high school students aged 12-18. We believe in seeing youth live in the freedom and purpose that Jesus offers and this is what we try to accomplish at Lifegate Youth. We do this through games, activities, sharing a message from the Bible, and creating a space where our youth feel welcomed and safe in small group discussion settings.

Lifegate Youth activities are posted each term on Facebook and Instagram. Please follow our pages to keep up to date with announcements.

Youth Pastor: Christie Lingley - 0403 682 711

Ministry Leader: Andrew Lingley - 0421 862 818

Child's details

First name *

Last name *

Gender *

Child's Date of Birth *

Age

Current year at school

School Attended *

Please provide us with any further information that is required such as: medical conditions, allergies, medication etc

If your child has a Medical Condition that requires medication or food allergy, please complete the following:

Please advise us of your child's medical condition/s and food allergy:

Is medication required

If yes, please provide us with further information such as the medication required, dosage and when it is to be taken

Parent/Guardian Information:

Last Name *

First Name *

Relationship to child *

Home Address *

Home City *

Home Postcode *

Mobile Number *

Email address *

Emergency Contact

In case of emergency and the Parent/Guardian is unable to be contacted, please provide an emergency contact.

Last Name *

First Name *

Contact Number *

Transport

I give permission for my child to leave Lifegate Youth with the below-mentioned drivers. Please provide the driver's full name and car number plate.*

(*This is to ensure your child's safety and so that we can verify they are leaving with the right people. If your child will not be picked up by one of the following drivers one week, please let Christie know on 0403 682 711.)

I give permission for my child to use public transport or walk to leave Lifegate Youth events. *

Permission and Indemnity Section

Please read the following points and indicate your response for each section.

I understand that if urgent medical attention is needed, that every effort will be made to contact the persons listed on this form. In the event that I cannot be contacted in an emergency, I give my permission for my child to receive such medical treatment, as the leader may deem necessary. I will be responsible for any and all related expenses.

Urgent Medical attention *

Information and Media

I consent to the following:

Information about my child being collected as required for accident/incident forms *

Use of any photographs or video footage that may be taken of my child to be used or shown as Lifegate Community Church see fit. *

Use of any photographs or video footage that may be taken of my child to be used on social media as Lifegate Community Church see fit. *

Further Information

I understand that all reasonable safety precautions will be taken at all times by the above mentioned group and that the leaders and those connected with the group cannot be held responsible for personal injury incurred by the child of this form.

I understand that the Lifegate Community Church cannot be held responsible for loss or damage of any items taken, by the child of this form, to Lifegate Youth.

Parent/guardian's signature:

By submitting this form, you are agreeing to the details on this form.

Date of permission given *

Christie Lingley

Youth Pastor

E: christie.lingley@lifegate.org.au

M: 0403 682 711