Groundswell Youth Permission Form 2026

To be completed for each youth annually

Child details (option to add siblings below)

First Name *

Date of Birth *

Gender *

Surname *

School Grade *

Allergies/Medical Conditions

Parent Details

First Name *

Mobile Number *

Relationship to child *

Last Name *

Email Address *

Mailing Address *

Privacy Declaration

I give permission for the personal details provided here to be given to appropriate supervisory/medical/emergency service personnel or Groundswell leaders as deemed necessary to care for my child. *

I understand photos taken of Groundswell teenagers and may be used for future Groundswell Instagram posts or public website use. *

Authorisations

By completing this form, I hereby give permission for my child/children to attend all scheduled Groundswell activities, unless I explicitly advise the Groundswell leadership team otherwise.
I give permission for my child to travel in a car driven by an approved Groundswell leader or a parent approved by a Groundswell leader unless I advise the Groundswell leaders otherwise. (Your child will not be in a car driven by a learner or provisional licence holder).
In the event of an accident I know every effort will be made to contact me first, but I do give permission for an ambulance to be called on my behalf.
I acknowledge that being part of a community involves mutual care and consideration, and therefore agree that unacceptable behaviour may result in my child being sent home and being temporarily or permanently prohibited from attending the activities of Groundswell.
I undertake to provide the Groundswell leaders with any new information relevant to the wellbeing of my child/children prior to them attending any & all scheduled Groundswell activities
Groundswell's activites and updates can be followed on the linktree.
Bulli Anglican Church's safe ministry policy's can be reviewed on the website.

Any extra things BAC needs to know?

Please tick *

I agree