Youth Permission Form 2026

2026 Permission Form

Alive & Revolution Youth
Thank you so much for taking the time to fill in this form - this is an annual form that helps us to make sure we have the most up-to-date information and permissions for your child. It's really important to us that our Youth Programs are a place where everyone who comes along feels safe and knows what to expect as they arrive; you providing this information to us is really helpful in making sure we can achieve that for your child.

If you have any trouble or questions at all regarding this form, please contact Ben Sterland at ben@communitylife.org.au. Thank you!
Young Person's Information
Full Name

First NameLast Name
Date of Birth

DayMonthYear
School Grade
Parent/Guardian Name (1)
Contact Email (1)
example@example.com
Parent/Guardian Name (2)
Contact Email (2)
Home Address

Street Address

Street Address Line 2

SuburbState

Postal Code
Does your child have any dietary requirements?
If yes, please indicate foods or beverages your child should/must not consume
Does your child have any medical conditions?
If yes, please list any medical conditions or allergies, and any medication or special care they require.
Emergency Contact Information
Emergency Contact Name (1)
Mobile Number (1)
Relation to Child (1)
Emergency Contact Name (2)
Mobile Number (2)
Relation to Child (2)
Declarations

If you would like more information on any of the following, please don't hesitate to get into contact with Ben
Photography - Do you authorise for photos of your child to be used on the church website, on church social media profiles or on printed materials?
Group Chat - Do you authorise for your child to be added into a Whatsapp group chat with leaders and other young people, so that they can hear about what's coming up each week and connect with others who come to the youth group?
Young person's phone number
Medical Treatment
Liability
Declaration
Your Name
Relation to Child
Permission Form Signed Date

DayMonthYear
Signature
Should be Empty:

2026 Permission Form

Young Person's Information

Emergency Contact Information

Declarations