Student Application - Canvassing Program

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Parent's Contact Details


Alternative / Emergency Contact


Medical


Authorisation

If you are under 18 years of age, your parent/legal guardian must fill in the following:

As a parent and/or legal guardian of the above applicant I am in favor of he/she attending the canvassing program and participating in all activities, including those off campus, unless otherwise specified in writing. I hereby release Eastward Missionary College from liability in case of accident or illness, and understand I am responsible for any charges incurred in treatment of my child's illness/ accident. In case of emergency, I understand every effort will be made to contact me. In the event I cannot be reached, I hereby give permission to the first aid team at the canvassing program to administer first aid as deemed appropriate and/or if necessary to hospitalise, and in which case for the hospital staff, to administer anesthesia and medications or perform surgery as required, on the above applicant.

Eastward may use pictures of the above applicant taken during the program for promotional and/or illustrative purposes

 


Participant Agreement

By clicking the submit button below you agree that the information you have entered in this application form is true and correct to the best of your knowledge.

Submit Application

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