Pod Parent/Carer Permission 2025

Parent/Carer Permission for all Pod activities in 2025

Child's Details

First Name *

Last Name *

Mobile Number

Tip: Optional - we'll send the occasional reminder for upcoming Pod events

Email Address

Tip: Optional - we'll send the occasional reminder for upcoming Pod events

Date of Birth *

Street Number and Name *

Suburb *

Postcode *

School *

School Grade *

Dietary Requirements for leaders to be aware of

Tip: Leave blank if not applicable

Dietary - Other *

Medical conditions or learning difficulties for leaders to be aware of

Tip: Leave blank if not applicable

Parent / Carer Details

Parent / Carer First Name *

Parent / Carer Last Name *

Parent / Carer Mobile *

Parent / Carer Email *

Medicare Number *

Sign Out Preferences *

Other:

Parent/Carer Declaration

I consent to my child becoming a member of the Pod Youth program. I will encourage my child to attend and participate regularly and to cooperate with the leaders and other children.

In any emergency, should I not be contactable, I authorise the leaders in charge of the Pod Youth Group to arrange for my child to receive such first aid, medical or surgical treatment as the leader may deem necessary at any time during the activities. I further authorise the use of Ambulance and/or anaesthetic by a qualified medical practitioner if in his/her judgement it is necessary. I accept responsibility for payment of all expenses associated with such treatment.

I agree to indemnify and hold harmless the Busselton Baptist Church and any individual staff or voluntary leaders against all claims arising out of any injury to my child and the relevant activity being undertaken, unless such injuries result from a failure in the duty of care of the Busselton Baptist Church, individual staff or volunteer leader.

I give permission for my child to be photographed and/or recorded during the course of the activity for the purposes of creating promotional material for the Church and/or its ministries.

Please indicate your consent below *

External Activities

I give permission for my child to participate in activities based outside of the Busselton Baptist Church building and to be transported in private cars arranged by the leaders of the Pod Youth Group.

(Please note that the leaders of Pod Youth Group will always seek to communicate in advance the details of any external activities including transport arrangements and only full licence drivers will be used.)

Please indicate your consent below *

Other comments or things to let us know: