Event Registration Details JULY SCHOOL HOLIDAY PROGRAM If you are human, leave this field blank. Contact details First Name * Last Name * Gender * Male Female Other How old is the person attending AYC? * Under 12 12 13 14 15 16 17 18 19 20 21-24 Country of Birth * Language spoken at home Address * Suburb * Postcode * Preferred Contact Number * Alternate Contact number Email Address * Emergency contact name * Emergency Contact Phone * Are you or your family receiving government benefits (we use this information to prioritise who we assist when we are overbooked) Jobseeker Youth Allowance Family Tax Benefit Disability Support Pension Carers Allowance Registrations are essential due to COVID laws. Please tick which activities events you would like to attend. Excursions and our cooking project have limited places CANCELLED CANCELLED CLOSED CLOSED CLOSED CLOSED CLOSED CLOSED CLOSED Conditions of Registration and Participation, please mark each box. * Participants maintain full responsibility for all their own personal belongings All participants must adhere to health and safety instructions and act in a manner that is safe for all other participants. Participants acting inappropriately, threateningly or showing disrespect to other people will be asked to leave. If behaviour is in breach of Australian Law AYC reserves the right to contact the appropriate law enforcement agency. When activities are overbooked AYC will prioritise attendance on the basis of who the program would most benefit. I will confirm my attendance on excursions and for the first aid course by responding to AYC contact. Should I not do so my place will be given to someone else. I / my son/ my daughter will not attend AYC activities is we are unwell, have a temperature, have a cough or ahve been in contact with anyone with COVID - 19. My image / my sons /daughters image can be used by AYC for promtional purposes. If I do not agree I will email email@example.com to notify management. In the event of any unforeseen accident or illness I consent for to obtain required medical assistance and agree to meet any costs relating to this treatment. The school holiday program is funded by, NSW Dept of Communities and Justice. I consent to my / my sons / my daughters details being used for this purpose. I will email firstname.lastname@example.org if I do not agree to this information being kept.