Youth Parental/Guardian Consent Form • Haven Baptist Church

First Name *

Last Name *

Gender *

School Grade *

Date of Birth *

Medical/Allergies or other important information

Dietary Requirements

Parent / Carer Name *

Phone Number *

Email Address

Home Address

Home City

Home State

Home Postcode

I consent for my child to attend Haven Baptist Youth activities *

Yes I give my consent

I acknowledge that my child will receive the first aid or access to emergency service if required. *

Yes, I acknowledge

I give consent for photos/videos including my child to be used in Haven Baptist Youth social media, publications and promotions. *

Yes