Next Gen Registration Form

NEXT GEN MINISTRY REGISTRATION FORM

This form is intended to assist leaders in case of any medical emergency during the course of participation in any Next Gen Ministry activity. For this reason, please compete fully, including the details of all who hold legal custody over the child, and return as soon as possible, prior to your child's involvement in the ministry activity.
This for is to be filled out by a parent/guardian of the participant
Child's Name*

First NameLast Name
Date of Birth*
School Year*
School Name
Child's Contact Number
Child's Email
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are there currently custody arrangements regarding your child?*

YesNo
If yes, please provide datails
Registering for (please choose appropriate)

10:30am Sunday Club (Age 3 - Grade 6)5pm Sunday Club (Prep-Year7)Ignite Youth Ministry (Grade 6-12)Spark Kids (Grade 2 - Grade 5)Developing Leaders (Grade 8 - Year 12)
Parent/Guardian #1
Name*

First NameLast Name
Primary Contact Number*
Email*
To be used for communicating information and important dates to families
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Relationship to Child*
Parent/Guardian #2
Name

First NameLast Name
Primary Contact Number
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState

Post Code
Relationship to Child

Emergency Contact #1

Please include at least ONE emergency contact who is different from the above two contacts
Name

First NameLast Name
Primary Contact Number
Relationship to Child

Emergency Contact #2
Name

First NameLast Name
Primary Contact Number
Relationship to Child

Permissions
By signing this form, I acknowledge that:
- I consent to my child’s participation in the activities of which I have indicated on page 1. I will encourage my child to participate and co-operate with the leaders and other participants at all times.
- I authorise the leader/s in charge of any activity conducted by Glen Waverley Anglican Church, to consent on my behalf, where it is impractical to communicate with me, for my child to receive any medical treatment deemed necessary.
- I understand that aspects of the program involve going offsite into the local area and I give permission for my child to participate in activities offsite and understand I will be notified in advance of this through the program leaders and can choose to withdraw my child from these events.
Media Release and Authorisation
I understand that there may be photographs and/or video footage taken of my child during ministry activities and understand that no royalty, fee or other compensation shall become payable to me by reason of any use.
I am willing for my child to be so filmed in appropriate settings. My child is also willing for photographs and/or video footage to be taken of them.*
I am willing for these photos or footage to be used to PROMOTE MINISTRY WITHIN GWAC in a way that does not identify their name or details. This includes photos/videos shown at any GWAC Gathered Celebrations (Sunday's & Friday Night Youth).*
I am willing for these photos or footage to be used to PROMOTE MINISTRY EXTERNAL FROM GWAC in a way that does not identify their name or details. This includes printed publications, the GWAC website and GWAC social media outlets.*
If there are specific information about taking photographs or using video footage that would be helpful for the team to know please specify below:
e.g. only post group photos, no photos during worship, prefer to only be used on instagram
Collecting my Child
Below are the names of other people allowed to collect my child (other than parents/guardians already listed)
Name 1

First NameLast Name
Name 2

First NameLast Name
Name 3

First NameLast Name
Name 4

First NameLast Name
(if a person other than the parent/guardian or authorised persons listed above os to collect the child on a particular day, permission must be given in person by parent/guardian on the day)
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Signed (Parent/Guardian)

Clear
Name of Signatory*
Date*

MonthDayYear
Date
Should be Empty:

NEXT GEN MINISTRY REGISTRATION FORM

This for is to be filled out by a parent/guardian of the participant

Parent/Guardian #1

Parent/Guardian #2

Emergency Contact #1

Emergency Contact #2

Doctor/Health Contact and Medication

Permissions