Youth Rush Nov to Dec 2025
Updates
First Name
Last Name
Address
City
State
Post Code
Phone/Mobile
Email
Age
Guardian’s Name
Guardian’s Last Name
Guardian’s Phone/Mobile
Medicare Number
Position on Card
Expiry Date
Do you have a Working With Children Check?
Yes
No
Working With Children Check Number
Working With Children Check Expiry Date?
Do you have an ABN?
Yes
No
What is your ABN Number?
Do you have a Square account?
Yes
No
Our initial plan is that all meals will be vegetarian. Do you require vegan meals?
Yes
No
Do you have any allergies? If YES, please type your allergens.
Are you a baptised member of the Seventh day Adventist church?
-Yes or No-
Yes
No
Why would you like to attend this program?
Have you had any experience with canvassing/doorknocking? If so, tell us about this experience.
If I suffer injury or illness while YOUTH RUSH Conference, the Literature Ministries or the organisation can arrange medical and emergency evacuation services as deemed necessary by the organisation, for my health and safety.
Yes
No
While at the YOUTH RUSH Conference, I understand that photos and videos of those covered by this registration may be taken and that this event could be live-streamed. I also understand that the photos and video footage may subsequently be used in productions and promotions (including print, internet, social media and audio-visual presentations) by Literature Ministries and the Victorian Conference.
Yes
No
I understand that my NAME, CONTACT NUMBER, MEDICARE, GENDER, CHURCH NAME and EMERGENCY CONTACT details will be collected and stored securely by Literature Ministries in Victorian Conference and will be held from the point of Registration until six months after the YOUTH RUSH. This data will only be used for the purposes of registration, contact and identification at the YOUTH RUSH and Literature Ministries in Conference and will not be shared with any third parties.
Yes
No
Referee’s Name (a Pastor, Elder, Youth Leader, School teacher)
Referee’s Position
Referee’s Phone/Mobile
Is there any additional information you would like to add with your registration?
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