HZY NP PARENT Form • Horizon Church

HORIZON YOUTH PARENT WAIVER

Hi Parent/Guardian!

You are receiving this form as your young person has attended a Horizon Youth Program. In order for your young person to participate in this program we would appreciate your consent by providing contact details and signing the participation waivers. All information is covered by our privacy policy. You can locate a copy of this at https://www.hz.church/privacy/

YOUNG PERSON DETAILS

First Name *

Last Name *

Date of Birth *

Gender *

Young Person Contact Number *

Allergies Information *

Tip: If no allergies, please type NIL

Medical Action Plan *

Tip: If no Medical Plan, please type NIL. If so, please email a plan through to youth@hz.church.

Behavioural Action Plan *

Tip: If no behaviour plan, please type NIL. If so, please email a plan through to youth@hz.church.

PARENT/GUARDIAN DETAILS

Parent/Guardian Name *

Parent/Guardian Relationship to Child *

Parent/Guardian Mobile Number *

Parent/Guardian Email *

Emergency Contact Number *

Tip: (Parent mobile number is preferred. Please re-enter even if the number is the same as above)

CONSENT TO INVOLVEMENT

ONSITE AND OFFSITE ACTIVITIES

I acknowledge that the activities listed below can be hazardous and that my child participates at their own risk.

I am consenting to activities including:

games
jumping castles & inflatables
swimming
skateboarding
events that are a part of the program

I understand that the church will take reasonable steps to provide a safe environment for my child and to ensure that all equipment supplied by them for the activities is a reasonable standard. Activities are that all held offsite will be advised. To ensure children are well covered for, HZY Staff and volunteers are required to hold a current WWCC and abide by NSW Child Safe Standards, ACC, Protection Policy and Horizon Code of Conduct.

I acknowledge that the church will not be liable for any injury that may be suffered by my child, which arises either directly or indirectly from, or in connection with, the activities listed below incorporated in this form.

I hereby agree to indemnify the church against any and all claims arising from, or in connection with, any injury that may be suffered by my child, or that my child may cause to another person, as well as any loss or damage to property, equipment or personal effects belonging to my child, or any other person, arising either directly or indirectly out of or in connection with the activities listed below incorporated in this form.

Incorporated into the authorisation for my child participating I accept the Horizon Youth Participation Guidelines which have been provided with this document.

I consent/do not consent to engagement in onsite and offsite activities as listed above *

I consent

I do not consent

ONLINE AND DIGITAL CONSENT

Horizon Youth considers the need for privacy of individuals identity and requires the parent/legal guardian to be active in protecting at risk participants in use of online and digital telecommunication platforms for the development and care of young people.

This may include my child participating in online activities and events hosted by Horizon Church Staff and volunteers including:

video calls with other young people
live stream delivery of the program Friday night Youth, other content etc.
use of social media (eg. Instagram, Facebook)
other online and digital platforms deemed beneficial for delivering program content

I consent/do not consent to engagement in online and digital activities as listed above *

I consent

I do not consent

MEDIA WAIVER

The Programs experience will be captured in photographs, video, and audio. Horizon Church reserves the right to use the material for promotional purposes. I consent/do not consent for my child to be captured on photographic, video and audio media and that such content may be used on social media and any other online platforms used by Horizon Church including in YouTube Live Streams, Horizon Youth YouTube Videos and on Horizon Youths Instagram account. This includes submissions in social media competitions and pre-recorded videos. These materials will be publicly available on social media and any other online platforms used by Horizon Church.

I consent/do not consent to engagement in media as listed above *

I consent

I do not consent

GENERAL WAIVER

TRANSPORTATION

I hereby consent for Horizon Youth volunteers and/or staff to provide transport when required for my child to and from the Programs. This includes transportation with a licenced driver (provisional or unrestricted), public transport and/or any ride sharing services.

MEDICAL TREATMENT CONSENT

I agree that the church may authorise on my childs behalf whatever medical treatment my child may require (this includes, but not limited to, ambulance attendance and hospital treatment). I agree to pay all medical expenses incurred.

I understand that every effort will be made for the listed emergency contact to be notified.

PRIVACY DECLARATION

I understand Horizon Youth may collect and use information about my child for the purpose of providing promotional material. I consent to my childs personal details being used for the promotion of future Horizon Church events and products. This information will be held in accordance with their privacy policy and always remain confidential.

CONTACT CONSENT

I hereby consent for my child to be contacted via the contact details provided by Horizon Church volunteers and/or staff.

The unenforceability or invalidity of any clause in this Waiver shall not have an impact on the enforceability or validity of any other clause. Any unenforceable or invalid clause will be regarded as removed from this Waiver to the extent of its unenforceability and invalidity.

I consent/do not consent to conditions as listed above *

I consent

I do not consent

Parent/Guardian consenting to all the above

By submitting this form, you are agreeing to the terms and conditions of entry above.

First Name *

Last Name *

Relationship to Child *

Date *