2026 St Luke's Youth Registration • St Luke's Liverpool

Thank you for registering your teen for St Luke's Friday Night Youth Group!
Please fill in the form below so that we will have all the details we need to take good care of your youth.
This form is to be filled out only by the youth's parent/guardian.

Youth's First Name *

Youth's Last Name *

Date of Birth *

Sex *

School Grade *

Youth's Mobile Number

Youth's Email Address

Media Permissions *

Yes

Tip: I give permission for photos/videos of my child to be photographed or recorded for the purpose promotional material for St Luke's Anglican Church in both printed and digital format.

Dietary Requirements/ Allergies / Medical Conditions *

Tip: If none, write 'none'

Prohibited Persons *

Tip: Is there anyone who is legally restricted from seeing your child? If none, write 'none'

Parent/carer Details

Parent/Carer's Full Name *

Parent/Carer's Phone Number *

Parent/Carer's Email Address *

Emergency Contact (Different to parent/carer named above)

Emergency Contact Full Name *

Emergency Contact Number *

Authorisations and Expectations

I give permission for my child to attend all scheduled St Luke's Youth Ministry activities, unless I advise St Luke's Youth Ministry leaders otherwise.
I give permission for my child to travel in a car driven by an approved St Luke's Youth Ministry leader or a parent approved by a St Luke's Youth Ministry leader unless I advise the St Luke's Youth Ministry leaders otherwise. (Your child will not be in a car driven by a learner or red provisional licence holder).
I authorise the St Luke's Youth Ministry leaders, in the event of an emergency, to obtain at my expense any medical, ambulance, rescue or other services that are considered necessary for my child.
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 St Luke's Youth Ministry.
I will provide the St Luke's Youth Ministry leaders with any information relevant to the wellbeing of my child prior to him or her attending a St Luke's Youth Ministry activity.
I confirm that the information given in this form is true and correct, and will advise St Luke's Youth Ministry of any changes to this information.

Comments

Tip: Do you have any questions, concerns or additional comments for us?

Click 'Register Another Youth' to register another child.
Click 'Submit' to confirm registration.