Junior Methodist Youth Fellowship (JMYF) Registration Form • Eight Mile Plains Methodist Church

Student Details

First Name *

Last Name *

Preferred Name

Date of Birth *

Gender

School Grade *

Mobile Number (if any)

Email Address (if any)

Home Address

Home Address *

Home Suburb *

Home State

Home Postcode

First Parent / Guardian Details

Parent / Guardian 1 Name *

Parent / Guardian 1 Mobile *

Parent / Guardian 1 Email *

Second Parent / Guardian Details

Parent / Guardian 2 Name

Parent / Guardian 2 Mobile

Parent / Guardian 2 Email

Medical Information

Does your child have any allergies? *

Please list any allergies and any treatment required. (e.g. anti-histamines, Epipen)

Does your child have any other medical conditions? *

Please list medical conditions and treatment required.

Special Needs Child

Please tell us about any special needs to help us care for your child.

Christianity

Is your child a Christian?

If not, would you like to know more about Christianity and Baptism? *

Parental Consent

I give permission for my child to attend Junior Youth Fellowship at Chinese Methodist Church In Australia, EMP Inc. (hereinafter to be referred as EMP MC). I understand that Junior Youth Fellowship operates from 7:00pm to 9:15pm. I am responsible to look after my child outside this time. *

I agree.

Photography/videography waiver: I understand that my child may be photographed or recorded on video during church programs and/or events. I provide consent for my child's image to be used in either print, electronic, or video form for EMP MC Sunday Service live streaming / promotional purpose of future church-based activities. *

I agree

No, I do not consent

I release EMP MC ministers, pastors, employees, leaders and representatives from any liability of unintended or unexpected accidents which might occur during participation in the program/events. In the event of accident or illness to my child, I give permission to obtain medical assistance or treatment as may be necessary and to engage any medical professionals (including ambulance and hospital) and I agree to pay for those expenses incurred. I understand all effort has been given for leaders and volunteers to be trained on to provide a safe and welcoming environment at EMP MC. *

I agree.