PARENT/GUARDIAN DETAILS *

First Name

Last Name

ATTENDEE DETAILS *

First Name

Last Name

DOB *

MM

DD

YYYY

Do you have any Dietary Requirements, Allergies, Anaphylaxis *

Yes (please specify below)

No

Do you have any Medical conditions we need to be aware of? *

Yes (please specify below)

No

Emergency Contact *

First Name

Last Name

Medical Permission *

I authorise a leader of Ruach Youth to arrange for my child to receive such first aid and/or medical treatment as may be deemed necessary. This includes calling an ambulance or seeking hospital or centre treatment. I accept responsibility for payment of all expenses associated with such treatment.

Agree

Photography Permission *

I permit my child to be photographed and/or videoed during Camp activities and for appropriate images to be used in church presentations and publications, including Ruach websites, newsletters and social media, in accordance with Ruach's Safe Youth Ministry Policy.

Agree

Disagree

Participation Permission *

I give permission for my child to participate in Ruach Youth activities that are conducted under the supervision of authorised Ruach leaders and in accordance with Ruach’s safe ministry policies and procedures. I acknowledge that my child participates in Ruach Youth activities at his/her own risk. I understand that Ruach will take reasonable steps to provide a safe environment for my child and to ensure that all equipment supplied by them for the activity is of a reasonable standard.

Agree

Liability Release *

I acknowledge that Ruach will not be liable for any injury that may be suffered by my child, which arises either directly or indirectly from, or in connection with Ruach Youth activities. I hereby agree to indemnify Ruach Ministries against any and all claims arising from, or in connection with, any injury that may be suffered by my child, or that my child may cause to another person, as well as any loss or damage to property, equipment or personal effects belonging to my child, or any other person, arising either directly or indirectly out of or in connection with Ruach Youth activities.

Agree