Fill in your details for the Water Sports Day Please enable JavaScript in your browser to complete this form.Personal informationType of Registration *Youth (Under 18 years)Adult volunteerVolunteer's First and Last Name *FirstLastVolunteer's Email *Volunteer's Phone *Parent/Guardian's Full Name *Parent/Guardian's Email *Parent/Guardian's Preferred Phone *Student's First and Last Name *FirstLastSchool grade in 2021 *789101112Swimming ability *BeginnerIntermediateStrongBronze medallionCurrent first aid certificate *YesNoMedical informationEmergency contact (full name):Emergency contact mobile:Medicare no: *Medicare Expiry Date: *Medicare Position no: *Medical Information (only tick if you have a prescription for the following)Asthma medicationEpipenDo you have any life-threatening allergies? *YesNoEnter details of your allergy/iesDo you have any dietary requirements? *YesNoEnter you dietary requirementsFurther comments (any information relevant to the safety and participation of the student you are registering)Indemnity and ConsentSun Protection: It is expected that you/your child/children come to this event with a hat, t-shirt (that covers shoulders) & sunscreen. I acknowledge that I will ensure my child/children attend with these items. Should my child attend the event without a hat, t-shirt & sunscreen, Young Life Australia in the first instance will call me and request I provide Young Life with the finances for them to purchase the items for my child and in the second instance will request my child remain in shaded areas, therefore excluding them from some activities. *I agreeConsent to medical attention: I, the undersigned confirm my consent to the activities I/my child/children will engage in while on a Young Life activity or camp. I acknowledge the staff and volunteer agents of Young Life will take all possible care but cannot be held responsible for unforeseen accident or illness arising. I hereby consent to medical, hospital, rescue procedures being employed in the best interests of myself/my child and that I shall be notified as soon as possible should the continuance of such procedures be necessary. *I agreeDisclaimer: In the unforeseen event of personal injury or illness sustained while on a Young Life activity or camp, or the loss of personal property except where such property was held in the custody of Young Life staff or volunteer agents when lost while on a Young Life activity or camp, I hereby release, and exempt, and indemnify the organisers, sponsors, and all other persons involved in the organisation of the Young Life camp, trip, excursion, from all action, proceedings, demands, costs, expense, and claims whatsoever made or taken by any person arising out of my own/my child/my children’s participation in such camp, trip, or excursion. *I agreeDiscipline: If in the event you or your child's behaviour is deemed by the organisers to be inappropriate or compromises the safety and/or health of other Attendees on the camp, trip or excursion, then Young Life reserves the right to send you/your child home, at your expense, at the earliest possible time, by the most effective mode of transport, in conjunction with your co-operation. *I agreeMedia Consent: Young Life may take photos &/or video footage at Young Life activities to commemorate the event and use for promotional purposes. Tick the box below if you agree to photos or footage of you/your child/guardian being used. *AgreeDisagreeSignatureClear SignatureYour privacy: The personal contact/address details you supply on this form will be entered into our database. We may use it to send you further information about Young Life Australia. Young Life Australia adheres to the Privacy Act and will not disclose this information to third parties. If you would like to know what information Young Life holds about you please call 1300 557 647.I consent to receiving information from Young Life AustraliaPhoneSubmit
