Parent Consent Form

Village Church Under 18 Parent Consent Form

This form is to consent to your child attending programs run by Village Church for children and youth under 18.

Child's Full Name *

Date of Birth

School Grade

Mailing Address

Mailing Address Line 2

Mailing City

Mailing State

Mailing Postcode

Emergency Contact Name

Emergency Contact Phone Number

Other Information

Are there any medical conditions that would be helpful for the team to know about your child? (Allergies etc)

If yes, does the child have any medication to be aware of?

Please note that the team are not able to distribute medication to your child. However, medication can be stored with the first aid kit incase needed by your child. Please talk to the team if this applies to your child.

Consent

I consent to my child taking part in Village Church under 18 programs where they will be cared for by Village Kids Team or Village Youth Team while signed into the programs. I understand that accidents happen and the responsibility of the child falls onto the parent/guardian, however, the team at Village Church will do all they can to prepare safe places, programs and people to ensure activities are as low-risk as possible. I understand that in the unlikely event of a safety concern, the team will follow the appropriate safety pathway. I have viewed and understand the safety pathway at Village Church for reporting a safety concern.

PLEASE LET A TEAM MEMBER KNOW IF YOU DO NOT CONSENT TO YOUR CHILD BEING PHOTOGRAPHED

Consent

Yes, I consent on behalf of mentioned child

No, I do not consent

Preferred Name

Last Name

Mobile Number