MitchYouth - Parent/Caregiver Form

Child Information

Name *

Date of Birth *

Year at School (as of 2026) *

Does your child have any allergies, medical conditions or dietary requirements? *

Yes

Is there any extra information about your child that would be important for us to know?

Parent / Caregiver Information

Parent / Caregiver Name *

Parent / Caregiver Mobile Phone *

Parent / Caregiver Email *

Permissions

Do you give permission for your child to travel by hired bus to an offsite event or activity? *

Yes

In the event that we require private vehicle transport to an offsite activity, do you give permission for your child to travel in the car of a MitchYouth leader, who is fully licensed and insured? MitchYouth will never be alone in a car with a leader. There will always be multiple MitchYouth per vehicle. *

Yes

I give permission for my child to be in photos on MitchYouth & Mitcham Hills Church Social Media/Website. *

Yes - full permission

Yes - back of head/ non-identifying ONLY

Signature *common.clear

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MitchYouth - Parent/Caregiver Form

Child Information

Parent / Caregiver Information

Permissions