Date & Time
13 February, 2024 18:00 - 20:00
16 out of 20 remaining tickets available
Type
Price
Quantity
Jesus Club Single Ticket (1 meeting)
16 Remaining
Price
$5.00
Quantity
Jesus Club whole term (5 meetings)
16 Remaining
Price
$25.00
Quantity
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Jesus Club Single Ticket (1 meeting)
0
Personal Information
First Name
*
Preferred Name
*
Primary Contact phone number
*
Mobile Number
Interests/Likes
Member's living arrangement
Alone
Group home
With family member
Other
Last Name
*
Name of the person filling out this form
*
Date of Birth
*
Email Address
Dislikes
How will the member usually transport to and from Jesus Club?
Emergency contact details
Primary contact name
*
Primary contact phone number
*
Relationship to member
*
Primary contact email
Safety / Medical Information
Allergies
*
Tip: Write 'nil' if no allergies
Is there a care / risk management plan?
*
Yes
No
Medical Issues
*
Tip: Write 'nil' if no medical issues
Please provide details of care/risk management plan
Jesus Club Member/Carer Agreement
I, the Jesus Club member/parent, or carer of the Jesus Club member, acknowledge that I / the Jesus Club member, will participate in Jesus Club activities, such as discussion about the Bible and give permission for the following (regarding the Jesus Club member)
*
To go on outings outside of formal Jesus Club program time and supervised by Jesus Club leaders
For photos or videos of me to be taken and occasionally posted on our church or the Jesus Club Community website, social media pages, and newslettersb
For occasional videos to be taken of me for special church events & leader training
For relevant information about me to be shared with leaders for the purpose of giving me appropriate care
Jesus Club whole term (5 meetings)
0
Personal Information
First Name
*
Preferred Name
*
Primary Contact phone number
*
Mobile Number
Interests/Likes
Member's living arrangement
Alone
Group home
With family member
Other
Last Name
*
Name of the person filling out this form
*
Date of Birth
*
Email Address
Dislikes
How will the member usually transport to and from Jesus Club?
Emergency contact details
Primary contact name
*
Primary contact phone number
*
Relationship to member
*
Primary contact email
Safety / Medical Information
Allergies
*
Tip: Write 'nil' if no allergies
Is there a care / risk management plan?
*
Yes
No
Medical Issues
*
Tip: Write 'nil' if no medical issues
Please provide details of care/risk management plan
Jesus Club Member/Carer Agreement
I, the Jesus Club member/parent, or carer of the Jesus Club member, acknowledge that I / the Jesus Club member, will participate in Jesus Club activities, such as discussion about the Bible and give permission for the following (regarding the Jesus Club member)
*
To go on outings outside of formal Jesus Club program time and supervised by Jesus Club leaders
For photos or videos of me to be taken and occasionally posted on our church or the Jesus Club Community website, social media pages, and newslettersb
For occasional videos to be taken of me for special church events & leader training
For relevant information about me to be shared with leaders for the purpose of giving me appropriate care
