DBC Youth Information Form
Date of Birth
-- None --
Are there any people restricted/prohibited from contact with your child?
Who else do you permit to pick up or drop off your child? (Please list)
I authorise the leader in charge of this program my child is attending at Dubbo Baptist Church to arrange for my child to receive first aid and medical treatment as a trained first aid person may deem necessary.
I authorise the use of calling an ambulance by a trained first aid person if in his/her judgement it is necessary. You will be promptly contacted if we feel this step needs to be taken.
I accept responsibility for payment of all expenses associated with such treatment.
I permit photos to be taken of my child to be used in church presentations and/or publications
Add Another Child/Youth