Stirling North Youth Group
February to May 2024
Young Person's Full Name
First Name
Last Name
Date of Birth
-
Day
-
Month
Year
Date
What school year is your child in?
Address
Street Address
Street Address Line 2
City
Post code
I, the parent/guardian of my child named above, agree with the following statements:
I give permission for my child to attend the youth group weekly on Sunday evenings from 7pm to 8.30pm in the Stirling North Parish building
I give permission for my child's photo to be taken and used on the church's social media
I give permission for my child to go home by themselves
I have indicated below any permanent or temporary medical or other condition(s) including special dietary and medication needs, which should be known about my child: (please write "N/A" if this does not apply to your child)
Emergency Contact Name:
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Name of Parent/Guardian
First Name
Last Name
Date
-
Day
-
Month
Year
Date
Signature of Parent/Guardian
Submit
Should be Empty: