Kyogle Youth Action Permission Slip

By filling and signing this form you give permission for your young person to attend this event and engage in the activities held.
If applicable you are also giving your young person permission to travel to and from the event using a bus service organised by KYA. It is your responsibility to organise pick up / drop off at the agreed meeting point at the times given by KYA.
By signing this form you also agree for us to hold onto your information and share it with NSW Health if in the unlikely event there is an incident of COVID-19 and contact tracing is required. Thanks for your co-operation.
If you have any concerns about this process please feel free to contact us on (02) 5601 5997.
You can also email us at
Kyogle Together Inc. acknowledges the Gullibul, Githabul, Wahlubal and Banjalang people who are the Traditional Custodians of the land and waters within the Kyogle Local Government Area, and we pay our respects to Elders past, present and emerging.