Switch Youth Registration • Bridgeman Baptist Community Church

Participant Details

First Name *

Last Name *

Date of Birth *

Gender *

Attendee's Email Address *

Attendee's Mobile Number

School *

School Grade *

Do you attend Bridgeman Baptist Church on a Sunday? *

Yes - I've been attending for a while.

Yes - I've just started attending.

No - I only attend Friday Night Switch.

Participant's Medical Information:

Medicare / Health Insurance Details

Medicare Number *

Medicare Reference Number *

Private Health Care Provider

Membership Number

Allergy / Medical Condition Details

Do you have any dietary requirements, other allergies or medical conditions we should be aware of? *

Yes - Food Allergies (Dietary Requirements)

Yes - Other Allergies

Yes - Medical Conditions

Description of Food Allergy

Description of Other Allergies

Medication / Treatment Required - Allergies

Description of Medical Condition

Medication / Treatment Required - Medical Conditions

Description of Other Concerns

Family & Emergency Contact Details

Primary Parent Emergency Contact

Parent Emergency Contact Full Name *

Relationship *

Phone Number *

Primary Parent's Email Address

Home Street Address *

Home Suburb *

Home Postcode *

Other Emergency Contact

Other Emergency Contact First & Last Name

Relationship

Phone Number

Code of Behaviour

As an attendee of Switch Youth I agree to uphold the following code of behaviour set out by the Switch Youth Leadership Team.

Please review and sign your acceptance below.

Click here to view the Switch Youth - Code Of Behaviour

Participant's Signature *

Tip: Please note by entering your name into this field this is equivalent to your written signature.

Participant's Full Name *

Date *

Terms and Conditions of Attendance

As a Parent / Guardian of the participant attending Switch Youth, I agree to the following Terms and Conditions as a condition of attending Switch Youth or related Switch Youth events.

Click here to view the Switch Youth - Terms and Conditions

Parent / Guardian's Signature *

Tip: Please note by entering your name into this field this is equivalent to your written signature.

Parent / Guardian's Full Name *

Date *

Switch Youth Photo Permission

We occasionally will choose to capture some photos at Switch Youth events. These may be used for publicity such as Church Newsletters, Church Website, Switch Facebook & Instagram accounts, and other promotional activities.

We respect that some parents / guardians may prefer for their child not to be present within these photos. To assist the team please indicate below your photo permission preference.

Photo Permission Given *

Privacy Policy

By selecting "submit" you are confirming that you have read and agree to the Bridgeman Baptist Community Church Privacy Policy.

I have read and agree to the Privacy Policy.