Youth Group Registration (Full)


This is the full registration form for Youth Group.

If you have registered for Youth Group, P1, Day Camp or Go West through Cleveland Uniting Church in the last 12 months, and your medical, emergency contact or other details haven't changed, you can click here to complete a shorter registration form for Youth Group

If in doubt, continue with the full form :)

Participant Details

Participant Contact Details

These are contact details for the participant and are optional.

If these details are supplied, we will include your child in:

  • Our weekly SMS reminder (Youth Group + P1)
  • Monthly email news letter. (All Youth and Families Participants)

Home Address


Parent/Family Contact Details

Emergency Contact Details

Indemnity and Authorisations

Media Release

I give my permission for my child to be photographed, videotaped or recorded. I understand that this material (including name and congregation or activity) may be used and disclosed for the following purposes:

 •In promotional or information materials produced by the Church

 •In worship and materials prepared by or for the Church  

•On the Church’s website and social media platforms  

•As otherwise permitted or required by law.

Privacy Policy

Privacy Statement
We collect your personal information to enable us to further our mission, respond to your request and maintain contact with you. We may also collect sensitive information about you. You give us your explicit informed consent to our exchanging your information with any part of the UCAQld and any third party service provider or professional advisor for these purposes, or purposes reasonably related to them and also for any other purpose you have consented to or as authorised by law. If you provide us with personal information about another person, please make sure that you tell that person about this privacy statement. Further information about what personal information and sensitive information is; as well as why and how we collect, hold, use and disclose it; and how you can access your personal information is available in our  Privacy Policy which you can obtain from  our website. (