CHARGE Youth Indoor Rock Climbing 2026 • St Bart's Anglican Church

Youth 0

CHARGE Youth Indoor Rock Climbing Excursion

On July 24th CHARGE Youth will be having a social night of Indoor Rock Climbing at Climb Toowoomba.

Participants must pre-register and have this form completed by parents/guardians in order to participate.

A waiver form (located on the Climb Toowoomba website) must also be completed.

Transport to/from the venue is to be arranged by individuals.

WHEN: Friday 24th July 2026. Climbing from 7pm-9pm. (Youth are able to arrive from 6:30pm).

WHERE: Climb Toowoomba, , 25 Prescott Street, Toowoomba

COST: $30 each (includes climb pass and gear hire. Unlimited climbs.

Personal Information (of person attending)

First Name *

Last Name *

Date of Birth *

School Grade (leave blank if team)

Email Address

Mobile Number

Emergency Contact

Emergency Contact #1 Name *

Emergency Contact #1 Phone *

Emergency Contact #2 Name *

Emergency Contact #2 Phone *

Medical Information

Please list all relevant medical conditions (including health, allergies or neurodiverse needs) of the person attending, so that we can best care for them.

Medical Information

Photo Permission

During the selected Youth Ministry activity/activities, St Barts, Toowoomba may be taking photographs and video footage to use to promote future parish events, do you give permission for St Barts, Toowoomba to use photographs and video footage that may involve the person attending in such promotions (include Parish website, Facebook Page, Videos etc.)

Photo Permission? *

Indemnity

I authorise St Bart’s to obtain medical information and attention (including first aid or paramedic assistance) for the person attending, which they consider necessary in the event of illness or injury and will indemnify ACSQ for any medical costs so incurred.

I understand that St Bart’s staff and volunteer team will exercise all reasonable care and control of the people participating in activities but will not be responsible for or liable in respect of any illness or injury I/my child may suffer during activities.

Further I agree to indemnify The Corporation of the Synod of the Diocese of Brisbane, its employees, agents, and officers for any liability, loss, damage, or expense incurred in dealing with any claim in relation to damage to or loss of property caused by the wilful act of myself/my child.

Indemnity Confirmation *

Name of Parent/Guardian completing this form (or self if over 18) *

Date of Form Completed *

Team 0

CHARGE Youth Indoor Rock Climbing Excursion

On July 24th CHARGE Youth will be having a social night of Indoor Rock Climbing at Climb Toowoomba.

Participants must pre-register and have this form completed by parents/guardians in order to participate.

A waiver form (located on the Climb Toowoomba website) must also be completed.

Transport to/from the venue is to be arranged by individuals.

WHEN: Friday 24th July 2026. Climbing from 7pm-9pm. (Youth are able to arrive from 6:30pm).

WHERE: Climb Toowoomba, , 25 Prescott Street, Toowoomba

COST: $30 each (includes climb pass and gear hire. Unlimited climbs.

Personal Information (of person attending)

First Name *

Last Name *

Date of Birth *

School Grade (leave blank if team)

Email Address

Mobile Number

Emergency Contact

Emergency Contact #1 Name *

Emergency Contact #1 Phone *

Emergency Contact #2 Name *

Emergency Contact #2 Phone *

Medical Information

Please list all relevant medical conditions (including health, allergies or neurodiverse needs) of the person attending, so that we can best care for them.

Medical Information

Photo Permission

During the selected Youth Ministry activity/activities, St Barts, Toowoomba may be taking photographs and video footage to use to promote future parish events, do you give permission for St Barts, Toowoomba to use photographs and video footage that may involve the person attending in such promotions (include Parish website, Facebook Page, Videos etc.)

Photo Permission? *

Indemnity

I authorise St Bart’s to obtain medical information and attention (including first aid or paramedic assistance) for the person attending, which they consider necessary in the event of illness or injury and will indemnify ACSQ for any medical costs so incurred.

I understand that St Bart’s staff and volunteer team will exercise all reasonable care and control of the people participating in activities but will not be responsible for or liable in respect of any illness or injury I/my child may suffer during activities.

Further I agree to indemnify The Corporation of the Synod of the Diocese of Brisbane, its employees, agents, and officers for any liability, loss, damage, or expense incurred in dealing with any claim in relation to damage to or loss of property caused by the wilful act of myself/my child.

Indemnity Confirmation *

Name of Parent/Guardian completing this form (or self if over 18) *

Date of Form Completed *

Observer Only 0

CHARGE Youth Indoor Rock Climbing Excursion

On July 24th CHARGE Youth will be having a social night of Indoor Rock Climbing at Climb Toowoomba.

Participants must pre-register and have this form completed by parents/guardians in order to participate.

A waiver form (located on the Climb Toowoomba website) must also be completed.

Transport to/from the venue is to be arranged by individuals.

WHEN: Friday 24th July 2026. Climbing from 7pm-9pm. (Youth are able to arrive from 6:30pm).

WHERE: Climb Toowoomba, , 25 Prescott Street, Toowoomba

COST: $30 each (includes climb pass and gear hire. Unlimited climbs.

Personal Information (of person attending)

First Name *

Last Name *

Date of Birth *

School Grade (leave blank if team)

Email Address

Mobile Number

Emergency Contact

Emergency Contact #1 Name *

Emergency Contact #1 Phone *

Emergency Contact #2 Name *

Emergency Contact #2 Phone *

Medical Information

Please list all relevant medical conditions (including health, allergies or neurodiverse needs) of the person attending, so that we can best care for them.

Medical Information

Photo Permission

During the selected Youth Ministry activity/activities, St Barts, Toowoomba may be taking photographs and video footage to use to promote future parish events, do you give permission for St Barts, Toowoomba to use photographs and video footage that may involve the person attending in such promotions (include Parish website, Facebook Page, Videos etc.)

Photo Permission? *

Indemnity

I authorise St Bart’s to obtain medical information and attention (including first aid or paramedic assistance) for the person attending, which they consider necessary in the event of illness or injury and will indemnify ACSQ for any medical costs so incurred.

I understand that St Bart’s staff and volunteer team will exercise all reasonable care and control of the people participating in activities but will not be responsible for or liable in respect of any illness or injury I/my child may suffer during activities.

Further I agree to indemnify The Corporation of the Synod of the Diocese of Brisbane, its employees, agents, and officers for any liability, loss, damage, or expense incurred in dealing with any claim in relation to damage to or loss of property caused by the wilful act of myself/my child.

Indemnity Confirmation *

Name of Parent/Guardian completing this form (or self if over 18) *

Date of Form Completed *

Date & Time

Youth 0

CHARGE Youth Indoor Rock Climbing Excursion

Personal Information (of person attending)

Emergency Contact

Medical Information

Photo Permission

Indemnity

Team 0

CHARGE Youth Indoor Rock Climbing Excursion

Personal Information (of person attending)

Emergency Contact

Medical Information

Photo Permission

Indemnity

Observer Only 0

CHARGE Youth Indoor Rock Climbing Excursion

Personal Information (of person attending)

Emergency Contact

Medical Information

Photo Permission

Indemnity