Nexus Youth Parent Database 2021 • Nexus Church

Thankyou for helping us! Please complete this form for each child in your family to ensure we have up to date contact details, allergy information and photo permissions.

Child's Details

Child's First Name *

Email Address (if applicable)

Child's Last Name *

Child's Date of Birth

School Grade

Parent / Primary Carer Information

Parent / Guardian Name and Relationship to child

Parent / Guardian Phone Number *

Parent / Guardian Email Address *

Photo and Video Permission

Please select whether you wish to allow photos of your child to be used in publications and social media.

Your child may be included in single or group photographs during Nexus Youth programs. These photos or videos are used to promote the wholesome fun and educational content of Nexus Youth programs and your child will not be identified or named.

By selecting yes below, you grant permission for Nexus Church or Nexus Youth to use single or group photographs that include your child for promtional purposes only.

If you do not give permission, please select "no" and ensure that your child wears a red wristband when attending any Nexus Youth program. Red wristbands are readily available at all registration desks or on entry to any Nexus Youth program and will help our team of photographers know to respect your preference.

Photo use permitted *

Allergy Information

Does your child suffer from any of the following allergies? (please select)

Please detail any known allergies below:

Please indicate below if your child is known to have an anaphalactic allergic reaction or has had this type of reaction in the past. If this is relevant for your child, action plans and relevant medication (eg epipen) need to be provided to staff.

Known Analphalactic Reaction to Allergy

Car Permissions

In an unlikely event, do you agree to allowing your child/ren to be driven home by a license holder (Youth Leader). At all times, there will be two youth leaders present with them in the car.

I give my child/ren permission to ride in a car driven by a Youth Leader with a license *

Yes