Youth Activity Registration Form - Core Gift Training

Please complete this form to register a young person for the EmpowerME Young Women's Program Discovering Your Core Gift workshop, Wednesday July 10th at 10:00am.

We will be in touch nearer to the date with more information. 

Does the participant have any physical/medical conditions or any disabilities staff or volunteers may need to be aware of (e.g. allergies, dietary requirements, disability or have a carer / support worker?)*This field is required.
I am aware that this program encourages a safe space for all young people and participants agree not to harass or annoy others in any way. Participants will respect any buildings, vehicle or property they encounter. Participants will not be under the influence of alcohol or drugs. Participants have been informed that if they choose to bring personal belongings they are their own responsibility to look after and the program facilitators and the Shire of Murray hold no responsibility if these items are broken, damaged or lost. Participants agree not to bring items that may be considered dangerous. Participants have been informed if their breaches the behaviour policy of the program they will be asked to leave the program immediately and emergency contacts will be informed about their behaviour.*This field is required.
Staff and volunteers do not provide care beyond basic supervision. If a young person has specific needs that require expert care, such as that of a support worker, these must be provided or arranged by parent/guardian prior to the participant attending the program. Staff and volunteers cannot administer medications or assist with ongoing medical issues. I will speak to staff or volunteers if I have any questions.*This field is required.
I acknowledge the Shire of Murray is not liable for any loss, damage or injury to property or person as a consequence of my or my child’s participation in the program. I acknowledge that I am liable for any damage to property or person caused by my or my child. I have read and understand the conditions as outlined on this page. I understand the Shire of Murray may take photos and videos of participants for the purposes of marketing. In the event of injury, I understand I may be required to pay any expenses incurred including ambulance costs. I understand some Shire of Murray programs are operated by volunteers. I understand many of the Shire of Murray youth programs are ‘drop-in’ and I understand it is not the responsibility of staff or volunteers to ensure participants stay on the premises and they are not liable for any actions taken by participants if they choose to leave the venue.*This field is required.