A seperate Youth Special Needs Registration can be worked through with the Director of Youth Ministry if any of the needs listed above require extra care or supervision.
Please provide Action Plan for Anaphylaxis or other Action Plan related to Allergic Reactions if required.
1. I understand that the information provided in this form will be handled according to The Privacy Act 1988. 2. Conduct Code: Students conduct should adhere to sound moral principles, all youth group rules and policies of Infusion Youth (hereafter referred to as "IY")and Desert Life Church LTD. The presence or use of tobacco, alcoholic beverages, intoxicants or nonprescription drugs or expressions of profanity or vulgarity verbal or otherwise or immodest clothing will not be permitted. Any student who violates youth group rules, is disruptive or is not cooperative with the program or others in attendance is subject to dismissal at parents/guardian expense and may be banned from future events. 3. General and Emergency Medical Authorisations: I agree that IY may authorise on my child's behalf whatever medical treatment he/she may reasonably require (This includes, but is not limited to, ambulance attendance and hospital treatment). I (Parent/Guardian) agree to pay all medical expenses incurred for said treatment. I understand that IY will take all reasonable steps to provide a safe environment for my child and to ensure that all equipment supplied for a church activity and/or event is fit for the purpose. I hereby agree to indemnify IY, including but not limited to its volunteers, employees, and authorised officers, against any and all claims arising from, or in connection with, any loss, or injury and/or damage that may be suffered by my child or my child's cause to another person or another person possessions. 4. I consent to my child attend weekly IY events and engaging in all activities, and I consent to IY & Desert Life Church LTD using my son/daughter's first name, as well as photos, media, recordings, information or quotes about his/her experience at the event in print, media or electronic form for marketing, public relations, fundraising and advertising purposes. The information recorded on this application form is accurate and complete.