Vine Youth Registration Form - 2018

Vine Youth is a youth ministry of Macquarie Anglican.

Please register your child for 2018 by completing this form.

If you would like to discuss this form with Macquarie Anglican staff, please call, message, or email Ryan Carter, Apprentice Minister, on 0434 956 525 or

Privacy Declaration

Macquarie Anglican respects your privacy.

When you provide us with personal information by participating in church events/activities, visiting a website, or otherwise, you agree to this personal information about you and your children (under 18 years old) being handled as set out in the policy available on our website.

The personal information in this form will be made available to the Vine Youth Leaders, who will treat this personal information confidentially. The personal information in this form may also be shared with medical and emergency services if considered necessary.

Child Details

Health Information & Restrictions

Parents/Caregivers Details

Parent/Caregiver #1

Parent/Caregiver #2

Additional Emergency Contact (Alternative to Parents/Caregivers)


Authorisations and Expectations

By accepting these conditions and submitting this form:

I permit my child to fully participate in Vine Youth from 6 May 2018 through 31 December 2018.

I permit photographs and video of my child to be taken while participating in Vine Youth to be used by Macquarie Anglican to promote the youth ministry.

I permit, in the case of a medical emergency, the doctor chosen by a Vine Youth Leader to secure proper treatment for and/or order hospitalisation, injection, anaesthetic, or surgery for my child as named. I understand that every effort will be made to contact me prior to instituting such procedures.

I acknowledge and agree that children attending Vine Youth must be signed in and out by a parent/caregiver. I agree to advise the Vine Youth leaders of the names of any other authorised adults who can sign my child in and out.

I confirm that the information given in this form is correct. I agree to advise the Vine Youth Leaders of any changes to this information.