Youth Alive 2026 • Eternity Church Morwell

Fresh Youth 0

Please read the following instructions prior to filling this form out

.Make sure you fill in a seperate form if you have more than one individual attenting
By filling this form you agree to the Church safety policies and procedures enforced by the church for this event

Youth Information

First Name

Date of Birth

School Grade

Last Name

Gender

Parent/ Guardians Mobile Number

Home Address

Home City

Home Postcode

Home Address Line 2

Home State

Medical ID

Medical Allergies/ Concerns or Dietary Requirements

Details of Ongoing Medication

Can the Child Self Administer? *

Yes

Medicare No. *

Ambulance Cover

Yes

If during an activity, urgent medical attention is required by my son/daughter and I cannot be contacted, I authorize the relevant leader to take such action as may be necessary and I agree to indemnify Eternity Church and its leaders from all responsibility relating to the action. An ambulance may be called in the case of a medical emergency, which the parent/caregiver will presume all responsibility for. If an ambulance is called, a parent/caregiver will either travel with the ambulance, or meet the child/young person at the hospital. I understand if I fail to neglect to provide sufficient or current information in writing to enable the proper treatment of my son/daughter, no liability will be accepted for any injuries or illness which he/she may suffer as a result.

Medical Release *

I agree

I Don't Accept

Emergency Contact 1 - Name *

Emergency Contact 1- Relationship *

Emergency Contact 1 - Number *

Emergency Contact 2 - Name *

Emergency Contact 2 - Number *

Emergency Contact 2- Relationship *

Photo/ Video Release *

Accepted

Decline

BY FILLING OUT THIS FORM :-

I acknowledge that my son/daughter has permission to be involved in scheduled activities as advertised in the church calender and/or other publications involving this Youth Camp. I will ensure that a leader is in attendance before leaving my son/daughter at any program session. I will accurately complete any "sign in/out procedures at the program" that may be available at the program session (only you, or the person authorized by you on this form, will be able to collect your child at the end of this session.) I will collect my son/daughter as soon as possible at the conclusion of any program session. I will attend to, collect or remove my son/daughter immediately if requested to do so for reason misbehaviors, illness, injury or any other emergency situation.

Parent or Guardians Name *

Date This Form was Signed *

Payment

Cost: $20 cash on the day or Pay your Youth Pastor/ Coordinator $20 prior to the event.

Want to invite a non-Christian Friend? Let us know, we have a handful of free tickets for them!

Don't forget money for dinner!

TCC Tickets 0