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RPC Multi-Purpose Consent Form 23/24
Anything written on this form will be held in confidence. The leaders need to know these details in order to meet the specific needs of your child.
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* Indicates required question
Child's details
Name
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Class
*
Your answer
School
*
Your answer
Church
*
Your answer
Address
*
Your answer
Please select all organisations at RPC that your child attends:
*
Crèche (Pre-school)
RPC Kids (Nursery-P3)
Sunday School (P1-P7)
Grid (Yr8-Yr12)
7 o'clock club (up to P4)
Place (Yr11+)
Toddle Inn (Birth-Nursery)
Zone (P2-P7)
Ignite (Yr8-Yr10)
Required
Contact Information
To be used in case of emergencies and for updates
Name
*
Your answer
Relationship to child
*
Your answer
Contact Number
*
Your answer
Email
*
Your answer
Alternative contact if unavailable
Name
*
Your answer
Relationship
*
Your answer
Number
*
Your answer
If you do not wish to receive text messages / emails from RPC Youth, please tick the box below. Text messages / emails will include trip details, upcoming youth events, reminders etc.
I do not wish to receive text messages / emails from RPC Youth
If you would like your young person to be informed of trips and receive reminders about different youth events, then please provide their mobile number and/or email address below.
I am happy for you to contact my young person about the activities that are taking place.
Number
Your answer
Email
Your answer
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