Neon Youth • Pittwater Anglican Church

Neon Registration

Child's Details

First Name *

Gender *

Home Address *

Home Postcode *

School Grade *

Child's Email Address

Last Name *

Date of Birth *

Suburb *

School *

Child's Mobile Number

Medical and Safety information

Does your child have Medical and Care Needs that we should know about?

Are there any persons prohibited from seeing your child?

Does Your Child have any Dietary Requirements or Allergies?

Can Paracetamol be given to your child *

Ambulance Cover *

Medicare Number

Medicare Position on Card

Medicare Expiry Date

Authorisations and Expectations

Please make sure you read and respond to the following statements

Photo & Video Permissions

I give permission for photos/videos of my child taken at Neon events to be displayed publicly, in an appropriate manner, (online and in print) unless I advise the Neon leaders otherwise.

Photo/Video Permission *

Car Travel Permissions for Offsite Events and Weekends away

I give permission for my child to travel in a car driven by an approved Neon leader or a parent approved by a Neon leader unless I advise the Neon leaders otherwise. (Your child will not be in a car driven by a learner or provisional P1 licence holder).

Car Travel Permissions *

Other Permissions and Expectations

I give permission for my child to attend all scheduled Neon activities, unless I advise the Neon leaders otherwise.
I give permission for my child to participate in online video meetings run by Neon, and for those to be recorded for internal compliance purposes in accordance with our safe ministry guidelines.
I authorise the Neon leaders, in the event of an emergency, to obtain at my expense any medical, ambulance, rescue or other services that are considered necessary for my child.
I acknowledge that being part of a community involves mutual care and consideration, and therefore agree that unacceptable behaviour may result in my child being sent home and being temporarily or permanently prohibited from attending the activities of Neon.
I will provide the Neon leaders with any information relevant to the wellbeing of my child prior to him or her attending a Neon activity.
I confirm that the information given in this form is true and correct, and will advise the Neon leaders of any changes to this information.

Authorisations and Expectations *

Parent / Caregiver Details

Parent Name *

Parent Mobile number *

Parent email *

Date This Form Was Completed

If you have any questions about this permission form, please contact Mia Wentzel: mia@pittwateranglican.church