PBC youth information form 2025 • Parramatta Baptist Church

Hey Parents,

Thank you for taking a couple of minutes to complete this form and ensure we have up to date information for your child/ren in 2025. We ask that this information is resubmitted at the beginning of each year so that we can best care for your child/ren. To complete this form for multiple children, please click on the red "Add another person" button and provide information sperately.

If you have any questions at all, please do not hesitate to contact the youth ministry leadership team:

Ben Wilson (Youth Pastor) - Ben@parramattabaptist.com
Sophie Pocknall (SUP coordinator) - SUP@parramattabaptist.com
Ray Viko (Emerge coordinator) - Emerge@parramattabaptist.com
Emily Adams (SMYGs coordinator) - SMYG@parramattabaptist.com
Joel Robinson (Arise coordinator) - Arise@parramattabaptist.com

Thank you!

Young Person's Information

First Name *

Date of Birth *

Last Name *

School Grade *

Parent's Email Address (1) *

Parent's Email Address (2)

School

Home Address *

Home City *

Post Code *

Does this person have any medical conditions? *

Medical Conditions & please note any special care required *

Tip: Mark as "Nil" if none

Does this person have any allergies? *

Allergies *

Does this person have any dietary requirements? *

Dietary requirements *

Young Person's Mobile Number

Young Person's Email Address

Note: Please only provide your young person's mobile and email if you are happy for leaders to contact your young person directly on occasion with information:

Emergency Contact Information

Emergency Contact (1) *

Emergency Mobile (1) *

Relation to Child (1) *

Emergency Contact (2) *

Emergency Mobile (2) *

Relation to Child (2) *

Photography

Photos and videos will be taken by leaders to capture events. These may be used on the church website, on social media profiles or on printed materials. For more information on our photography policy, please speak with Ben Wilson or program coordinators.

Which program will this young person be attending? *

SUP - Sunday Upper Primary

Emerge Youth

SMYGS - Sunday morning youth groups

Arise youth

Declarations

Has this person attended this program before?

Yes

Do they know anyone who already attends youth? What is their name?

Medical treatment *

By selecting this box - I authorise suitably trained leaders and medical professionals to administer appropriate medical treatment (e.g. first aid, use of ambulance etc.) to my child and understand that I will be notified as soon as possible. I accept responsibility for expenses associated with such treatment.

Liability *

By selecting this box - I affirm my understanding that all duty of care will be taken by leaders for my children and they will not be liable for any misadventure.

Event-specific permission forms *

By selecting this box - I affirm that bringing my child to PBC Youth events will act as consent to any permissions required for that event (as outlined in the event specific permission form).

Supervision *

By selecting this box - I understand that supervision of my child is the responsibility of leaders between the times my child arrives to when they leave youth programs. How they are transported to or from programs is my parental responsibility.

Do you authorise your child to be driven (by fully and green 'p' licensed drivers) during PBC Youth events where necessary? *

I do

I do not

Declaration *

By marking this box and submitting this form I declare that I am the parent or legal guardian of the young person/s mentioned above. All information provided is accurate and up to date, and I reaffirm all permissions granted.

Your full name *

Relation to Child *

Permission Form Signed date *