Bull Creek Youth Registration 2026 • WPC Bull Creek

Youth Group Registration (Childs Details)

Bull Creek Youth is an activity of the Westminster Presbyterian Church Bull Creek Inc. (WPCBC). The activities include, but are not limited to: Bible studies, games and organised activities. Bull Creek Youth is primarily held at WPC Bull Creek, 32 Bull Creek Drive, Bull Creek, WA 6149 but will also include off-site activies and camps.

First Name *

Tip: Name of Child

Last Name *

Email Address *

Mobile Number *

Date of Birth *

School Grade *

Allergies *

Yes

Tip: Serious allergies (i.e anaphylaxis) including food allergies

Allergy Details

Do you need to carry and Epipen?

Yes

Medical Condition *

Yes

Medical Condition details

Do you need to self-adminster medication for your medical condition/allergy?

Yes

Next of Kin #1 Name: *

Next of Kin #1 phone number *

Next of Kin #2 name: *

Next of Kin #2 phone number *

Parent Declaration

I agree that: *

By submitting this form give my permission for my child to participate in Bull Creek Youth activities. I accept all reasonably foreseeable risks associated with the Bull Creek Youth program, including loss or damage to personal property or personal injury sustained by my child/children and will be responsible for any costs incurred on behalf of my child/children due to a medical emergency, accident or misdemeanour whilst attending Bull Creek Youth activities. I confirm that this information is correct and understand that failure to disclose changed or new information will be at my own risk.