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YOUNG LIFE AUSTRALIA
LEADER DETAILS AND ACKNOWLEDGEMENTS
Please make sure you have the following details on hand, before you complete this step.
Emergency Contacts
Medical Information
YOUR DETAILS
Step
1
of
4
25%
Your Name
(Required)
First
Last
DOB
(Required)
Day
Month
Year
Email
(Required)
Phone
(Required)
YL Area
(Required)
Select your local area
Armidale
Barossa Valley
Blacktown
Canberra
Gawler
Hobart
International
Melbourne
National
Redlands
Don't Know
Please indicate where you are interested in serving (if known)
(Required)
Volunteering in Schools
Clubs
Small Groups / Bible Groups
Committee
Camps / Adventures
Mentoring / Counselling
Fundraising / Events
Whereever there is need
What program will you be a part of (if known)?
Emergency Contacts
Emergency Contact 1 - Full Name
(Required)
First
Last
Emergency Contact 1 - Relationship
(Required)
Emergency Contact 1 - Phone
(Required)
Emergency Contact 2 - Full Name
(Required)
First
Last
Emergency Contact 2 - Relationship
(Required)
Emergency Contact 2 - Phone
(Required)
Medical Information
Is there anything (such as injuries or illnesses) either current or previous that could reasonably impact your ability to participate in programs, activities or events, or carry out the duties of your volunteer role??
Select Choice
No
Yes
Injury or Illness details
Please indicate whether you live with any of the following health conditions
Asthma
Anaphylaxis
Diabetes
Seizure of any type
Heart condition
None
Other (please indicate below)
Other health conditions
Is there anything else we should be aware of?
Select Choice
No
Yes
Comments
Young Life Australia’s staff and adult volunteers will periodically be given the opportunity to voluntarily participate in Adventurous Outdoor Activities facilitated by the organisation. Adventurous Outdoor Activities coordinated by Young Life Australia are delivered by qualified outdoor guides who plan and facilitate these activities in accordance with organisational policies that are benchmarked against industry standards. Young Life Australia staff and volunteers are not obligated to participate in these activities. Staff and volunteers who participate in these activities do so as voluntary participants who are aware of the risks and their obligations. Acknowledgement of Risk and Obligations This acknowledgement of risks applies to all Adventurous Outdoor Activities I may undertake as a Young Life Leader – be that as either a staff member or adult volunteer. I am aware that my voluntary participation in Outdoor Activities facilitated by Young Life Australia’s qualified outdoor guides will expose me to risks such as injury, illness, death and loss of or damage to my property. Typical risks may include but are not limited to hyperthermia, hypothermia, slipping on loose or icy surfaces, slipping on rocks, falling rocks, exposure, snake bite, bee stings and other insect attacks, burns, drownings, stepping into unseen holes, accidents during vehicle travel, navigation errors and becoming lost. To minimise risks I will endeavour to ensure that: - Prior to participation in an Adventurous Outdoor Activity facilitated by Young Life Australia I will read the relevant generic activity description; which provides a detailed description of the activity, including any potential risks - I will read the program specific activity planning information which is provided to me by Young Life Australia to ensure that it is within my capabilities to participate - I will inform Young Life Australia of any changes to my contact information and/or my medical information should ant of these details change - I am to carry food, water, medication, and equipment appropriate for the activity - I will advise the outdoor guide/s if I am taking any medication or have any physical or other limitation that might affect my participation in the activity - I will make every effort to remain with the rest of the party during the activity - I will advise the outdoor guide/s of any concerns I am having, and - I will comply with all reasonable instructions of the national organisation and their qualified outdoor guides.
Acknowledgment of Risk and Obligations
(Required)
This acknowledgement of risks applies to all Adventurous Outdoor Activities I may undertake as a Young Life Leader – be that as either a staff member or adult volunteer. I am aware that my voluntary participation in Outdoor Activities facilitated by Young Life Australia’s qualified outdoor guides will expose me to risks such as injury, illness, death and loss of or damage to my property. Typical risks may include but are not limited to hyperthermia, hypothermia, slipping on loose or icy surfaces, slipping on rocks, falling rocks, exposure, snake bite, bee stings and other insect attacks, burns, drownings, stepping into unseen holes, accidents during vehicle travel, navigation errors and becoming lost.
To minimise risks I will endeavour to ensure that:
- Prior to participation in an Adventurous Outdoor Activity facilitated by Young Life Australia I will read the relevant generic activity description; which provides a detailed description of the activity, including any potential risks
- I will read the program specific activity planning information which is provided to me by Young Life Australia to ensure that it is within my capabilities to participate
- I will inform Young Life Australia of any changes to my contact information and/or my medical information should any of these details change
- I am to carry food, water, medication, and equipment appropriate for the activity
- I will advise the outdoor guide/s if I am taking any medication or have any physical or other limitation that might affect my participation in the activity
- I will make every effort to remain with the rest of the party during the activity
- I will advise the outdoor guide/s of any concerns I am having, and
- I will comply with all reasonable instructions of the national organisation and their qualified outdoor guides.
I have read and understand the above requirements. I have considered the risks before choosing to sign this acknowledgement of risk. I acknowledge that I will take responsibility for my own actions and that signing this form will be deemed as full acceptance and understanding of the above conditions.
Media Consent
Young Life will take photos and/or video footage at Young Life activities to enable students/volunteers to have digital memories of their time. Some of this footage may also be used for promotional purposes e.g. on Young Life’s official social media pages and supporter communications.
I agree to the above statement
Injury Consent
In the unforeseen event of personal injury or illness sustained while on a Young Life activity or camp, or the loss of personal property except where such property was held in the custody of Young Life staff or volunteer agents when lost while on a Young Life activity or camp, I hereby release, and exempt, and indemnify the organisers, sponsors, and all other persons involved in the organisation of the Young Life activity, camp, trip, excursion, from all action, proceedings, demands, costs, expense, and claims whatsoever made or taken by any person arising out of my participation in such activity, camp, trip, or excursion.
I agree to the above statement
Medical Consent
I, the undersigned confirm my consent to the activities my child/children will engage in while on a Young Life activity or camp. I acknowledge the staff and volunteer agents of Young Life will take all possible care but cannot be held responsible for unforeseen accident or illness arising. I hereby consent to medical, hospital, rescue procedures being employed in the best interests of my child and that I shall be notified as soon as possible should the continuance of such procedures be necessary.
I agree to the above statement
Your Privacy
The personal contact/address details you supply on this form will be entered into our database. We may use it to send you further information about Young Life Australia. Young Life Australia adheres to the Privacy Act and will not disclose this information to third parties. If you would like to know what information Young Life holds about you please call 1300 557 647.
I consent to receiving information from Young Life Australia
Accurate Information
The information provided is true and accurate
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