Vine Youth Registration Form - 2020

Thanks for your interest in Vine Youth at Macquarie Anglican! Please fill out this form to register your child for this group for 2020.

Child's Details

Medical and Care Needs

Tip: i.e. chronic illness, allergies, dietary restrictions, medication we should know about?

Tip: i.e. behavioural concerns or restrictions, mental health needs (i.e. depression), etc.

Family and Emergency Contact Details

Parent/Caregiver 1

Tip: Providing a mobile number is helpful as it allows us to send updates by SMS

Parent/Caregiver 2

Emergency Contact (alternative to parent(s)/caregiver(s))

Privacy Declaration

Macquarie Anglican Church respects your privacy. When you provide us with personal information by participating in church events/activities, visiting a website or otherwise, you agree to 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, and medical and emergency services if considered necessary.

Authorisations and Expectations

By accepting these conditions and submitting this form I permit my child to participate fully in activities associated with Vine Youth from the 28th February 2020 - 31st December 2020 at Macquarie Anglican.

In a medical emergency, I give my permission for a doctor chosen by a Macquarie Anglican 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 also acknowledge and agree that any photographs or video of my child taken while participating in Vine Youth may be used by the church to promote further youth activities (i.e. during a church service,  on church premises).

I understand that teens attending Vine Youth must be signed in and out weekly by a parent/authorised adult. 

I confirm that the information given in this form is correct, and will advise the Vine yOuth leadership of any changes to this information.