StandOut Youth Permission Form - 2026 • Central Villages Anglican Church, Lawson

StandOut Youth Permission Form 2026

StandOut Youth Group is a combined ministry of Lawson Baptist Church and Central Villages Anglican Church.

Permission form to be completed for all young people under 18 years attending StandOut Youth in 2026.

Effective from January 2026 to December 2026, StandOut Youth Program.

Child Details

First Name *

Last Name *

Date of Birth *

Gender *

Place of Learning

Grade/Learning Stage *

Medicare Number

Position on card

Medicare expiry date

Ambulance Cover (Y/N) *

Please be aware that Medicare information is not mandatory but helpful to have in case of emergencies.

We will keep these details on file so that we do not have to ask for them prior to each event, unless you request otherwise. Please advise the StandOut youth leaders as soon as practical of any changes to this information.

Medical Needs

Does this child have any medical conditions that we should know about? *

(Please Specify)

In the event that you cannot be reached, do you give permission for a leader to administer this child paracetamol if deemed appropriate? *

Care Needs

Does this child have any care needs that we should know about? *

(Please Specify)

Is there anyone who is legally restricted from seeing your child? *

(Please Specify)

Dietary Needs

Does this child have any special dietary needs that we should know about? *

(Please Specify)

Other

Please provide any other necessary information

Parent/Caregiver 1 Details

First Name *

Last Name *

Mobile Number *

Other Number

Email Address *

Home Address *

Parent/Caregiver 2 Details

First Name

Last name

Mobile Number

Other Number

Home Address (if different)

Alternative Emergency Contact Details

First Name *

Last name *

Mobile Number *

Other Number

Privacy Declaration

Central Villages Anglican Church (one of our ministry supports), is exempt from the requirements of the Privacy Act 1988 as it is a small business. However, we seek to deal carefully with the personal information we collect and to do so in a manner consistent with your reasonable expectations.

The personal information in this form will be made available to

(a) the leaders involved in the running of the activities in which your child participates, and

(b) medical and emergency services if considered necessary.

Authorisations & Expectations

I give permission for photos/videos of my child taken at StandOut Youth Group events to be displayed publicly (online and in print) unless I advise the StandOut Youth Group leaders otherwise.

I, the parent or caregiver, agree to the above

I understand

I give permission for my child(ren) to attend Standout Youth Group in Lawson and surrounding areas, for both on and off site activities *

Yes

I give permission for my child to attend all scheduled StandOut Youth Group activities, unless I advise the Youth Leaders (the Leaders) otherwise.
I authorise the 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 a discussion between me (the parent/carer) and the Leaders to determine the best course of action. In extreme cases I acknowledge that I may be required to collect my child from an activity early, at my own inconvenience before a discussion is possible.
I will provide the Leaders with any information relevant to the wellbeing of my child prior to him or her attending a StandOut Youth activity, and update them accordingly if they change
I confirm that the information given in this form is true and correct, and will advise StandOut Youth Group of any changes to this information.

I, the parent or caregiver, agree to the above. *

I agree

Thank you for filling out this form! We look forward to getting to know your child(ren) more and encouraging them to grow in their faith!

- StandOut Youth Leaders