Teenagers Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Teenagers Residential Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent/Guardian 1 - Name *

First Name

Last Name

Parent/Guardian 1 - Address

If different to Teenagers Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent/Guardian 2 - Name

First Name

Last Name

Parent/Guardian 2 - Address

If different to Teenagers Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Medical Treatment Consent and Declaration *

I declare I have passed on the correct information regarding my child's medical condition. I give permission for Ignite Youth to obtain emergency medical, hospital or ambulance assistance and/or treatment for my child at any time they consider necessary, and acknowledge that I will be liable for any medical, hospital or ambulance expense incurred i the treatment of my child. I understand that the group leaders will make every effort to notify me before instituting such procedures.

I give permission for my child to be administered paracetemol if deemed necessary by the leaders of Ignite High youth group.

Covid Declaration *

I agree not to send my child to Ignite High if they – Have been diagnosed with COVID-19 and/or told to isolate, or have COVID-19 symptoms (cough, fever, sore throat, fatigue or shortness of breath)

General Activities

I give permission for my child to participate in all general activities at Ignite High. If any irregular activities are planned, Ignite Youth will advise me beforehand and seek extra permission.

Photo Release Permission *

I understand that Ignite High youth group may be captured in photographs and video and that Ignite youth reserves the right to use this material for promotional purposes.

Transportation *

It is the parents/guardian's responsibility to transport their child to and from an Ignite Youth event.

I agree for my child to be transported by an Ignite Youth leader in cases where parent/guardian transport is difficult, when an activity moves between more than one venue, or in an emergency

Contact Details Permission

Optional

I give permission for my details to be shared with other parents (eg. to coordinate ride sharing to Ignite High events).

Emergency Contact - Name *

First Name

Last Name