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Youth Health Declaration

Under the St John Ambulance Australia Management of Health Conditions Policy (Cadet/Youth Program), parents/guardians of members under the age of 18 years are required to inform St John of any health condition that affects their child’s enrolment or participation in the Program.

Youth Details
Parent/Guardian Details
Medical Information
Has your child been diagnosed with any of the following?
Epilepsy
Hearing/Vision Impairment
Respiratory problems (e.g. Asthma)
Allergic rhinitis (Hay fever)
Allergies (including anaphylaxis and hay fever)
Migraines/headaches
Conditions that affect behaviour (e.g., Autism, ADD, ADHD, ODD)
Mental Health Concerns
Learning difficulties
Heart problems
Diabetes
Anxiety
Do you have any further information about your child, either medical or behavioural, that you think we should know about?
Declaration

I declare that the information herein is true and correct. I acknowledge the requirement to provide St John NT with up-to-date and accurate information regarding my child's health including advising of any changes to my child's health condition, or any other condition that develops during their engagement with the Program.

Privacy Statement

St John NT is committed to protecting your personal information. Any information contained in this form will only be used for legitimate purposes by St John NT members and staff. St John will take all reasonable steps to ensure that the information we hold about your child is secure, accurate and up-to-date.

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