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The Heights Church

FUSE Participant form

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FUSE Participant Registration

  • Participant Information

  • Emergency contact information

    Will the above parent or guardian be the primary emergency contact
  • Medical and Allergy Information

    Are there any medical conditions that we should be aware of?
  • Please list any medical conditions or allergies, and any medication or special care they require
    I authorise the leader in charge of FUSE to arrange for my child to receive such first aid and medical treatment, as a trained first aid person may deem necessary. This may include the calling of an Ambulance. I accept responsibility for payment of all expenses associated with such treatment.
    Is your child on a restricted diet?
  • If yes, please detail
  • Additional information

    I give permission for my child to participate in activities outside of the normal meeting complex - where they are within reasonable walking distance.
    I give permission for my child to be transported in private cars arranged by the leaders of the FUSE group. (all transportation will be by full licensed drivers.)
    I permit photos taken of my child to be displayed on social media or FUSE promotion.
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