Youth Leadership Project 2024

Thank you for expressing interest in the Western Bulldogs Community Foundations' Youth Leadership Project. Due to the popularity of The Western Bulldogs Leadership Project, candidates must apply to participate by completing an online expression of interest form.

Please provide responses to the below questions.

Please confirm your information - Fields with a * are required

Nominee’s First Name *

Nominee’s Last Name *

Phone Number *

Nominee's Country of Birth *

Nominee's Date of Birth *

Nominee's Mother's Country of Birth *

Nominee's Father's Country of Birth *

Is the nominated young person of Aboriginal and/or Torres Strait Islander origin? *

Do you speak a language other than English at home? If so, please tell us what language. *

What is your cultural background?

The gender the Nominee identifies with? *

Street Address *

Suburb *

Postcode *

Local Government Area *

If Other, please specify the nominee's Local Government Area

What school does the nominated young person attend? *

What year level is the nominee? *

If not currently attending school, please describe the activities the nominee is undertaking below:

To take part in this program, will the nominee require any additional support? If so, please specify *

Does the nominated young person have any religious or cultural considerations that we should be aware of? If yes, please provide details: *

Does the nominated young person have any medical conditions and/or allergies that we need to be aware of? If yes, please specify: *

Does the nominated young person have any dietary requirements? If yes, please specify: *

Medication

Parent or Guardian Name *

Parent or Guardian Email Address *

Parent or Guardian Contact number *

Is the nominated young person’s emergency contact the same as the parent/guardian contact listed above? *

If no, please provide the nominated young person’s emergency contact name, number and email below:

Is an interpreter required to talking to this emergency contact? *

Is the nominated young person on NDIS? *

Do you consent for the participant being in photos? *

Do you have a casual/part time job? *

If selected other, please specify

What is your hoodie size? *

Has the nominee participated in any WBCF youth programs previously? *

Why does the nominee want to join the Youth Leadership Project program? *

Nominee's Email Address *

I would like to receive communications from the Western Bulldogs Community Foundation *

As the parent, I have read and agree with the

Youth Leadership Program terms and conditions Western Bulldogs Privacy Policy

Allow me to be contacted by sms

I would like to receive email communications from the Western Bulldogs Football Club, such as match day and membership information

Submit

Western Bulldogs Community Foundation Terms and Conditions

Before your child starts the Youth Leadership program, a parent/legal guardian must read and accept these terms and conditions on their behalf. You need to check the box above to show you understand and agree to these terms and conditions.

This program is run by the Western Bulldogs Community Foundation and partners.

If your child has not exercised for some time or has any health concerns, you should take them to visit a doctor. A doctor will be able to tell you if it is safe for your child to participate in the program. Your child might not be able to participate if they act inappropriately or if participation in the program is unsafe for them.

Your child might be at risk of injuring them self during program activities. You agree not to hold any person or organisation directly or indirectly involved with this program liable for loss relating to any personal injury to the extent permissible at law.

In case of an emergency, you consent to Program staff calling emergency services to take your child to a doctor or hospital for medical help - even if your child does not have ambulance cover. You grant doctors/other professionals permission to give whatever medical or surgical treatment they believe is necessary. You understand you are responsible for paying costs of medical attention, ambulance transportation and treatment if your child hurts them self. We may need to share some of your personal information with these medical professionals.

You must tell us if your child’s emergency contact details change or if their health changes during the program.

If your child needs to take any medication during program hours or camps, you need to tell Program staff before they start in writing in the registration form. If your child needs help taking medication during program hours and camps, all prescribed medication MUST be in a Webster (medication) pack (your chemist can assist you) and must include the name of the medication, dosage instructions and times when the medication is to be administered.

You understand you are responsible for your child’s safety whilst travelling to the program, after program sessions finish and/or whilst they are waiting to be collected from program activities.

Any health information collected by the Western Bulldogs Community Foundation is done so in accordance with the Western Bulldogs’ Privacy Policy, which can be found at www.westernbulldogs.com.au/privacy Information collected will only be used to help your child stay safe at sessions, for program administration; or to contact you/your child during the program or in the future. De-identified information might also be used for program research and evaluation.

You/your child may be sent information updates from the Western Bulldogs Community Foundation or Western Bulldogs Football Club - via email or SMS. These are done so in accordance with the Western Bulldogs’ Privacy Policy. If you/your child do not wish to receive email or SMS communication from the Western Bulldogs Community Foundation or Western Bulldogs Football Club, you can opt out at any time by emailing ‘OPT OUT’ to foundation@westernbulldogs.com.au.

The Western Bulldogs Community Foundation and partnering organisations take photos and video footage during programs, for social media, online and mainstream media use. If you and your child agrees they wish to be featured in photo and video footage, the Western Bulldogs Community Foundation or Western Bulldogs Football Club may use this content for program promotion, to share stories on social channels. We will store the photos safely, without identifying information. If you change your mind at any time we can delete photos. You accept that these photos could be used without being paid. If you do not want your child to be in photos or video footage, they do not have to. Please tell us that you do not consent to this upon registration.