Program Details
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Young Person Details
Gender
Culture & Diversity
Is the participant of Aboriginal or Torres Strait Islander descent?
Does the participant require an interpreter?
Does the participant have any cultural requirements?
Does the participant have any additional or complex needs?

A Supplementary Information Form will be sent to you and must also be completed

Are you under 18 years of age? (required)
Parent or Guardian Details

Privacy Collection, Use and Disclosure

Your personal and health information is being collected by Council for the purposes of you consenting to your or (your child’s) attendance at Youth Services Recreation Programs, Personal Development Programs and Committees: 

  • To consent to the use and disclosure of information to Council Staff involved in the Programs; 
  • To ensure young people are supported during specific program and general service delivery; 
  • Ensure parents/grandparents/guardians/workers or emergency contacts can be easily contacted if required; 
  • Assist Youth Services with strategic program and service planning, delivery and evaluation. 
  • Create an opportunity to provide you with promotional material about the services and programs 

Your information will be stored in Council’s Customer Database and used to identify you when communicating with Council and for Council to deliver services and information to you. 

The information you provide shall remain private within Council unless disclosure is permitted by law or consented to by you.  You may apply for access and/or amendment of the information by writing to the Council’s Privacy Officer. 

For further information on how your personal and health information will be handled, refer to Council’s Privacy Policy at:  www.wyndham.vic.gov.au/privacy-policy 

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Parent Signature (Young Person Under 18)
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