Youth Services Registration Form

Privacy Collection Statement

Your personal information is being collected by Wyndham City Council for the purpose of registering to attend a program(s) run by Youth Services. This information will be stored in Council’s database and used to identify you when communicating with the Council, as well as for the delivery of services and information.  By registering your details, you consent to the collection, use and disclosure of your personal information. Your personal information will be handled in accordance with the Privacy and Data Protection Act 2014 (Vic). For further information about how your personal information is handled, please visit Council’s Privacy Policy.

Your details
Parent/guardian consent (must be completed if you are aged under 18)
Your registration

Please note that Registration form DOES NOT need to be completed for Drop-In programs. Check in to be completed on attendance.

For Youth Services program information and locations, please click HERE

Please select all programs that you are registering to attend:
Emergency Contact
Dietary Requirements
Accessibility and support needs (Additional Requirements)
Do you require an interpreter?
Are there any other support needs Council should be aware of?

Please note: while every effort will be made to cater to these needs, this cannot be guaranteed

Cultural Diversity
Is the participant of Aboriginal or Torres Strait Islander descent?
Are there any other cultural requirements Council should be aware of?

Please note: while every effort will be made to cater to these requirements, this cannot be guaranteed

Medical Form
Tick all support need:
Medical Health Information Form (Asthma)
Maximum 2 files.
10 MB limit.
Allowed types: txt rtf pdf doc docx odt ppt pptx odp xls xlsx ods.
Usual signs and symptoms
Worsening signs and symptoms if applicable

1.   Sit the young person down and remain calm to reassure them. Do not leave the young person alone. 

2.   Without delay shake a blue reliever puffer (Airomir, Asmol, Epaq or Ventolin) and give 4 separate puffs through a spacer (use the puffer alone if a spacer is not available). Use one puff at a time and ask the young person to take 4 breaths from the spacer after each puff.  A Bricanyl Turbuhaler may be used in First Aid treatment if a puffer and spacer is unavailable. 

3.   Wait 4 minutes. If there is no improvement, repeat steps 2 and 3. 

4.    If there is still no improvement after a further 4 minutes – call an ambulance immediately (dial 000) and state the young person is having breathing difficulties. Continuously repeat steps 2 and 3 while waiting for the ambulance. 

One file only.
2 MB limit.
Allowed types: pdf doc docx odt ppt pptx.
Allergy Action Plan
One file only.
5 MB limit.
Allowed types: txt rtf pdf doc docx odt ppt pptx odp xls xlsx ods.
Young person’s awareness of specific triggers
Medical Health Information form (Epilepsy)
One file only.
2 MB limit.
Allowed types: pdf doc docx odt ppt pptx.
Awareness of specific triggers
Seizures

Medication Authorisation - Principles 

Wyndham Youth Services staff are not permitted to administer any medications to young people or children attending our programs, events, or services.

Only parents, guardians, or individuals with lawful authority are authorized to administer medication to young people or children during these activities.

Wyndham Youth Services staff are trained in Level 2 First Aid and will provide medical support within the scope of this certification.

Mobility/Accessibility Needs

Child safe commitment

Wyndham City Council is dedicated to the safety and well-being of all children and young people who participate in our Youth Services Programs. We have zero tolerance for child abuse and are committed to creating a safe, empowering environment where children's voices are heard and respected. The Council has established clear expectations for appropriate behaviour in engaging with children via a Child Safe Code of Conduct. If you have any concerns about a child's safety, please immediately contact our staff, one of our Child Safety Officers or the relevant authorities. Child safety is our highest priority.

Agreement on your Responsibilities and Information

These terms and conditions apply to regular and recurring programs run by the Youth Services team at Wyndham City Council (‘Council’). By registering to participate in a program(s), you agree to be bound by these terms and conditions.

These terms and conditions should be read in conjunction with any relevant program information, including the information published on Council’s website.

  1. ELIGIBILITY TO REGISTER

    1.1 In order to be eligible for the program, you must live, work, study or recreate in Wyndham and be aged between 12-25 years old.

    1.2 If you are aged under 18, you must have your parent or legal guardian’s consent to register for the program.  You acknowledge and agree that Council may contact your parent or legal guardian at any time to confirm that this consent has been provided.

  2. REGISTRATIONS

    2.1 Subject to a limit on the number of program participants, registrations are accepted on an ongoing, ‘first come first served’ basis.

    2.2 Council will advise you by email within 3 business days if your registration has been accepted.

  3. MAILING LIST

    Where you have opted in to join the Youth in Wyndham eNews, you acknowledge and agree that Council may periodically send you emails to the email address provided in your registration form.  You may unsubscribe from this mailing list at any time.

  4. EXPECTED BEHAVIOUR

    You agree to follow all directions of Council staff and program facilitators and be respectful towards and considerate of other program participants.

  5. LIABILITY

    5.1 You acknowledge and agree that you register for and participate in the program at your own risk.

    5.2 To the extent permitted by law, Council is not liable to you for any loss, damage, claim or expense (‘loss’) suffered, including but not limited to property loss or damage, personal injury and death, as a result of or in connection with your participation at the program except to the extent that any such loss is caused or contributed to by the negligent act or omission of Council.

  6. WITHDRAWAL OR CANCELLATION

    6.1 Council reserves the right to end your participation in a program where you are reasonably believed to have:

               a) submitted false, inaccurate or misleading information in your registration form; or

               b) breached these terms and conditions.

          6.2 Notwithstanding any other provision of these terms and conditions, Council reserves the right to cancel, change or modify a program at any time and/or to amend these terms and conditions.

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