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Immanuel Lutheran Church Buderim
Offering
About
Baptism
Marriage
Resources
Groups
Faith@Home
Kids
Youth
Calendar
Sermons
Youth
Children & Youth Event Registration
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Please enable JavaScript in your browser to complete this form.
Student's Name
*
First
Last
Which Events Will The Student Attend
*
GIG (Friday 3.30pm for primary children)
SOULARISE YOUTH (Friday 6.30pm Year 7 - 12)
MEN OF THE BACON (Thursday 7.00am Boys Year 9 - 12)
OTHER (please note in comments below)
Comments:
Student's School Year
*
Student's School
Student's Date Of Birth
*
Student's Gender
Male
Female
Guardian's Name/s
*
Guardian's Mobile Number/s
*
Guardian's Address
*
Guardian's Email
*
Emergency Contact Name & Number (please ensure we have at least 2 points of contact between Parent's Mobile and Emergency Contact)
Student's Medical Conditions / Needs
Student's Dietary Requirements And/Or Food Allergies
Anything Important We Should Know To Best Care For This Student?
Information Storage Consent (Required)
*
I consent to this information being stored by Immanuel Lutheran Church. It will be used only for youth ministry in accordance with the LCAQD Privacy Policy.
First Aid & Indemnity Consent (Required)
*
I agree that in the event of a medical emergency where I cannot be contacted that leaders will arrange the best possible medical care. I agree to pay in full for all medical costs involved. I will not hold liable Immanuel Lutheran Church or its agents for any loss or injury incurred.
Photo & Transport Consent (Optional)
I consent to the use of photos of my student for promotional purposes within Immanuel College or Immanuel Church.
I consent to my student being transported by a fully licensed youth leader (only for camps and overnight stay events which involve moving location during the event).
Parent's Full Name in BLOCK LETTERS
*
STUDENT COMMITMENT (Required)
*
I will respect people and help everyone have a good, safe, and fun time.
If I am disrespectful or make people feel unsafe then I may not be allowed to participate in activities, my parents may be phoned or asked to pick me
I understand that Immanuel Youth is completely drug and alcohol free.
Student's Full Name in BLOCK LETTERS
*
Date
*
Phone
Submit
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