Rev Registration Form • The Salvation Army Rev Church

WELCOME TO REV!

Thank you for your interest in registering your child(ren) in Rev - our Youth program for young people in grades 6-12.

Rev is the youth ministry of Revolution Salisbury City, held onsite on Friday nights during school terms from 7:30-9:30pm at 84-86 Lavender Dr, Parafield Gardens SA. Young people are also invited to be part of our church gatherings on Sunday mornings from 10-11:30am onsite at Revolution Salisbury City. For more general information about our program, click here to connect with us on Facebook or here to connect with us on Instagram.

Occassional offsite excursion are part of our programming but will require additional consent. Online activities are minimal and relate primarily to contact through Facebook messenger and Instagram regarding programming. High risk activities are limited to general sports activities on our ashphalt area. Group leaders are Megan and Sam Elms, and team members are from our wider Rev team. All leaders are screened, checked, and trained in accordance with Salvation Army policy.

In order for us to provide the best level of care while your child is under our supervision, we require that you fill out the registration form below. This form only needs to be filled out once per family per year. The information provided below will be treated confidentially within our team.

To view information about policy about how The Salvation Army is committed to keeping your cihld safe, click here.

If you wish you make a complaint about our program, please speak to one of our team leaders or click here.

First Name *

Last Name *

Gender

Date of Birth *

School Grade *

School

Address *

Address Line 2

City *

State *

Postcode *

Emergency Contact Name *

Email Address *

Emergency Contact Relationship *

Emergency Contact Phone Number *

Please detail the name and number of a secondary emergency contact if we are unable to reach you in case of emergency

Participant behaviour:

I, (name of individual participating) understand that I am responsible for my behaviour during the event/program/activity. I agree to the following:

- I will treat everyone fairly and listen respectfully to their views

- I will not put down or bully anyone

- I will not take photos or screenshot of others during online events

- I will not use abusive and bad language

- I will not treat others differently because of their race, culture, ethnicity, gender identity, age, size, mental or physical ability

If I break this behaviour code, I will be reminded by my leader and ask to comply. I will be given an opportunity to change my behaviour. If I continue to behave inappropriately, I may risk being restricted from participating and my parents/guardian will be made aware of this.

I have spoken to the participant/s named on this form to make sure they understand the behavioural expectations *

Yes

Parent/Guardian Permissions

I give permission as parent/guardian for the participant/s named on this form to take part in the overall activities of this program *

Yes

I give permission for the participant/s to be transported in The Salvation Army vehicles or private cars to be picked up/dropped off for Friday night programming or Rev Church on Sunday mornings by leaders of the Rev Youth program under the conditions outlined in The Salvation Army policy / procedure and as agreed with the activity leaders. *

Yes

I consent to the information about the individual named in Section A being collected as required for activity specific permission forms and accident/incident report forms.

I understand that if urgent medical attention is needed, that every effort will be made to contact the persons listed on this form. In the event that I cannot be contacted in an emergency, I give my permission for such medical treatment as the leader may deem necessary.

Medical treatment *

Yes

Image consent and release

The Salvation Army requires specific permissions from the parent/guardian of children regarding the use of images and videos.

Rev and Rev Church are active on social media on Facebook and Instagram platforms. This consent relates to publishing images and videos of your child permanently on these platforms. Please note that if previously specified that there is a court order in relation to your child, The Salvation Army will not publish any images or videos of them in adherence to their court order.

- I acknowledge that from time to time photographs or videos may be taken as part of participating in a program at The Salvation Army.

- I understand that these images will be taken in accordance with The Salvation Army policies and procedures (click to view on Page 3 of this document).

- Images may be displayed publicly. This may include use in print and electronic media, including the Internet and official social media platforms.

- The participant will also be asked for consent to publish their image.

- I understand that no identifying information will be displayed with images.

- I understand that my consent or consent of the participant can be revoked at any time.

I agree to the above image consent and release statement as above *

Parent/guardian initials and date *

By entering my initials and clicking submit, I agree that:

I confirm that the information contained on this form is true and correct.
I agree to inform the leader of any change to these details.
I understand due care will be taken by The Salvation Army personnel delivering this program.
I acknowledge and agree that The Salvation Army personnel cannot be held responsible or liable for any personal injury, loss or damage sustained by my child/adult as a result of their participation in the program.
I also understand that The Salvation Army is part of the Christian church and as such will run this activity acting on those principles and beliefs.
I have read the Privacy Notice available at this link: The Salvation Army’s Privacy Policy

Parent/Guardian initials and date *