Register for Safe Space

Whether you want to create, connect, or just chill, there is a space here for you. No pressure, just good vibes and a community that has your back.

Your Rangatahi | Youth Details

Participant Full Name *

Date of Birth *

Gender *

Ethnicity *

School Attending *

Home Address *

Parent / Guardian Full Name *

Relationship to Participant *

Parent / Guardian Email *

Parent / Guardian Phone Number *

Emergency Contact Full Name *

Emergency Contact Phone Number *

Medical Conditions, Allergies or Injuries (Leave blank if none)

Participation: I give permission for my child to participate in all Remain Youth activities.

Medical Consent: I give permission for first aid to be administered in case of injury.

Communication: I give permission for leaders to contact my child for youth-related updates (e.g., events, encouragement).

Media Consent: I consent to photos/videos of my child being used for Remain promotions.