Under 18 Participant Registration Form

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Thanks for being part of our event! To ensure we do our best for you and comply with all our legal and moral requirements we need you to fill out this form with your parent or guardian. :)

Participant First Name *

Participant Surname *

Participant Email *

Participant Address

Participant Phone number *

Participant Date of Birth *

YYYY

Participant Age (as at time of event.) *

Gender *

Male

Female

Parish and/or School

Medical Information

Any talents you would like to share?

Emergency Contact Full Name *

Emergency Contact Phone Number *

Relationship *

Family Doctor Name

Family Doctor Contact

Consent, Agreement & Permissions

The legal stuff. Please make sure you read these sections carefully so there are no surprises during or after the event.

Consent, Agreement, Code of Conduct & Permissions *

Involvement Consent: I/my child/my ward are permitted to to take part in this event. I agree and understand that the Diocese of Bunbury and event organisers reserves the right to exercise discretion to refuse entry to any person upon medical and/ or other grounds without providing a detailed reason for doing so.

Indemnity: I understand that while every reasonable precaution will be undertaken to ensure my/my child’s/my ward’s protection, I hereby release the Diocese of Bunbury and Event organisers from any and all liability in the event of any injury, accident, misfortune, damage or loss that may occur to my/my child/my ward and/or my/my child’s/my ward’s property while present at the event. Further, I indemnify the Diocese of Bunbury and Event organisers against all loss, including legal expenses, connected with or arising from any claims or demands in relation to my/my child’s/my ward’s attendance at the event.

Medical Treatment consent: I Give permission for the designated Youth Leaders, event staff and volunteers to obtain emergency medical, hospital or ambulance assistance and/or treatment for me/my child/my ward at any time they consider necessary. I acknowledge that I will be liable for any medical, hospital or ambulance expense incurred in my/my child’s/my ward’s treatment and I agree to pay those expenses. NB: The medical profession takes the view that a parent’s consent to medical treatment cannot be delegated to another. Medical consent forms have no legal status and a doctor has the right to insist on parental consent before treating a child. We have found, however, that medical staff find this type of general consent helpful.

Privacy Declaration: I also consent to photographs or video images of me/my child/my ward being used without acknowledgement, remuneration or compensation, in publications (print, websites, social media, emails, DVDs, CDs, etc.) and/or presentations of the Diocese of Bunbury. I also consent to my/my child’s name appearing in publications (print, websites, social media, emails, DVDs, CDs, etc.) and/or presentations of the Diocese of Bunbury.

Contact Authorisation: I give permission for myself/my child/my ward to be contacted by the Diocesan Youth Ministry Office in the future for other events.

Required

Youth Participant Code of Conduct

The Youth Participant Code of Conduct has been developed to ensure positive and respectful interaction between all people participating in Diocesan Youth Ministry Events. Youth Participant conduct should be characterised by common sense, politeness and cooperation. Participants should at all times be mindful that they are ambassadors for their parish/school.

I will:
1. Conduct myself in a respectful and Christian manner through language, dress, and behaviour
2. Listen and adhere to all lawful instructions given by Coordinators, leaders or volunteer members
3. Respect myself, other participants and leaders and the property of other participants and leaders
4. Keep my personal belongings with me at all times
5. Fully and actively participate in all activities, arriving promptly, and staying for the entire event
6. Maintain the spirit of the event
7. Report problems or incidents of any kind to a volunteer, including situations that make me feel uncomfortable
8. Act in accordance with the laws, regulations and rules of the event and of Western Australia
9. Avoid risk taking behaviour which could compromise the health and safety of myself or others
11. Refrain from violence towards participants, leaders and all other persons
12. Refrain from dangerous, demeaning, threatening (including bullying & harassment) or immoral behaviour

I will not:
13. Use rude or offensive language
14. Hurt, abuse, bully, or tease anyone
15. Upload, store, post on social media, or transmit via a mobile device inappropriate images of myself or others
16. Engage in actions that could result in injury and/or damage to property
17. Possess weapons of any kind
18. Purchase, possess, consume, or distribute alcohol
19. Purchase, possess, consume, or distribute banned drugs or misuse other medication
20. Engage in any form of sexual activity or sexual harassment
21. Purchase, download, possess, or distribute pornography

If a serious breach of any Code of Conduct occurs during the event, those affected should immediately advise a volunteer.
Youth Participants and their parents/guardians understand that failure to agree to and abide by the Youth Participant Code of Conduct will result in exclusion from the event.
· Breaches of discipline and disruptive behaviour, including bullying, will be dealt with in a manner that is fair and transparent, by more than one Church worker. Children and their parents will be advised of the consequences for breaching the Code of Behaviour. A three-stage process will be followed: the first stage will be a verbal warning; the second stage will involve informing the child’s parents; the third stage - if the behaviour continues - the child will be asked to leave the group. The child, parents and group leaders will be involved in the consultation.
· Children, or their parents, who are dissatisfied with any aspect of activities or services can follow a complaints procedure; namely, to inform the leader of the program or, when appropriate, to contact one of our Parish Safeguarding Officers.
Please note:
· the Diocese of Bunbury only accepts liability or responsibility for an incident or accident caused by the negligence or breach of statutory duty of the parish, its staff and volunteers
· it is the responsibility of the parents to be on time when dropping off or collecting children
· all participants must keep to the Code of Behaviour for all activities; otherwise they may be asked to discontinue their participation
· any concerns regarding the welfare and safety of children participating in Diocesan activities should be brought immediately to the attention of the Diocesan Safeguarding Officer or the statutory authorities.

I have read the above Code of Conduct and I/my child/my ward agree to follow it while attending Diocesan Events. I understand that if the Code is breached the Diocesan Youth Ministry Office may:
• Report my/my child/my ward misconduct to local statutory authorities, if the breach in any way violates local ordinances or laws
• Dismiss and escort me/my child from the venues of the event or call parents/guardians to collect me/my child/my ward.
• Ban me/my child/my ward from involvement in future Diocesan Youth Ministry Office events

I and my child/ward have read the above and agree to abide by the Participant Code of Conduct, the terms of this Authorisations, consent, permissions, agreements, and any rules notified to me by the diocese (collectively, “Rules”) from time-to-time. I understand that a breach of the Code of Conduct or Rules may result in the removal of my child/ward from the event. *

Participant

Parent/Guardian

Required

Privacy

The Diocese of Bunbury respects the right to privacy of individuals and is bound by the Commonwealth of Australia Privacy Act 1988. Every effort will be made to ensure that information presented on this form respects the privacy of individuals. Personal information collected will only be used for the purposes for Catholic Youth Ministry. The information will not be sold or disclosed to any organisation or individual (notwithstanding any legal requirement stipulated in the laws of the Commonwealth of Australia or its territories to disclose information).

Participant Name (Signature) *

Parent/Guardian Name (Signature) *

Parent/Guardian Contact Number *

Parent/Guardian Contact Email Address *

Signature Date *

YYYY

Diocesan Youth Ministry Office - Catholic Diocese of Bunbury

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