Enrol Youth - YL Armidale • Young Life Australia

First Name *

Preferred Name *

Tip: What do you friends call you?

Last Name *

Gender *

Date of Birth *

Tip: Make sure you use your birth year, not the current year!

Allergies / Health information *

School Grade *

Mobile Number *

Email Address *

Can Young Life take photos of you and publish them? *

Tip: We might want to publish photos of you when promoting Young Life and its programs

Parental Consent to Attend Young Life *

Parent/ Guardian (first name) *

Parent/ Guardian (last name) *

Parent/ Guardian (mobile) *

Parent/ Guardian (email)

Who is the Parent/Guardian to you (e.g. father, mother)? *

Is it OK for Young Life to contact your Parent/ Guradian? *

Yes

Yes, but only in emergencies

No

Tip: We may want to contact them in an emgency or to let them know about Young Life, its events and your involvement.

Why is it not OK for Young Life to contact your Parent/ Guardian?

Tip: You don't have to give a reason.