Trinity Youth Club: Registration Form 2026/2027
For young people in Years 8-12. A seperate form MUST be completed for each young person attending.
Young Person's Name
*
First Name
Last Name
Date of Birth
*
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Day
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Month
Year
Date Picker Icon
Address
*
Street Address
Town
State / Province
Post Code
School Attended and Class
*
Emergency Contact Details:
Name of Parent/Guardian:
*
First Name
Last Name
Relationship to young person:
*
Contact Number:
*
Email address:
*
example@example.com
Emergency Contact 2:
*
First Name
Last Name
Relationship to young person:
*
Contact Number:
*
Email address:
*
example@example.com
Medical Details:
Name of GP and Health Centre
*
Details of any known conditions, allergies, medication etc.
*
Any other needs or requirements that would be helpful for the leaders to know about:
*
In the event of illness or accident, having parental responsibility for the above named young person, I give permission for first aid to be administered where considered necessary by a trained first aider. If I cannot be contacted and my child should require emergency hospital treatment, I authorise a leader to sign on my behalf any written form of consent required by the hospital. However, I understand that every effort will be made to contact me ASAP.
During the time your young person will spend with us, photographs may be taken for use in church services e.g powerpoint presentations, church website and use on our social media pages. Please indicate below if you give consent for photos/videos to be taken of your young person:
*
Yes, photographs/videos may be taken of my young person.
No, photographs/videos may not be taken of my young person.
Please note there will be no supervision before 8pm or after 10pm. If your young person leaves the premises before the end of Youth Club leaders cannot be responsible for them. Please complete below:
*
My young person will be collected at 10pm
My young person has permission to walk home.
All young people attending Trinity Youth Club are expected to adhere to the Youth Club's CODE OF CONDUCT. Copies of this are available.
I confirm that the above details are correct, and give permission for my young person to attend Trinity Youth Club. Please sign below.
*
Submit
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