We love having visitors at INY. If you are new with us, please have your parent/caregiver fill out the form below.

This helps us in a number of ways, including your medical details, emergency contacts & parental consent.

If you have any questions, please don’t hesitate to contact us on 4736 3000.

Child's Name *
Child's Name
If available
Other information you need to inform us about your child
Custodial Issues *
Postal Information
Childs Address *
Childs Address
Parent/Guardian Contact Details
Emergency Contacts Name *
Emergency Contacts Name
How can we help? *
Parental Consent *
Medical Treatment Consent: I being the parent/guardian of the said child understand that whilst every precaution will be taken to ensure the good welfare and protection of my child, Imagine Nations Church, its staff and volunteers acting on behalf are hereby released from any and all liability in the event of any accident or misfortune, damage or loss that may occur to the child and their property. In the case of an emergency, I hereby give permission to the first aid staff/volunteers to ensure proper treatment for my child. I understand that every effort will be made to contact me before instituting such procedures. I agree to pay all such doctor, ambulance and hospital fees incurred on behalf of my child. I have attached a list of any health information about my child that the first aid staff need to know. Smoking, alcohol, drugs etc. will not be tolerated. I understand that if my child behaves inappropriately, I will collect them as soon as I am notified. Involvement Consent: I being the parent/guardian of the said child hereby give my consent that my son/daughter may participate in any activities they choose over the course of Imagine Nations Youth. Media Consent: I being the parent/guardian of the said child hereby give consent for my child to be captured in both photographs and videos at Imagine Nations Youth. Imagine Nations Church reserves the right to use this material for promotional purposes (digital and printed platforms). Imagine Nations Youth may be filmed and/or recorded by or on behalf of Imagine Nations Church for production and/or resale. It is a condition of entry that each audience waives any claim he or she might have in relation to inclusion of their likeness in such films or recordings. Connect Leader Phone Contact Consent: I being the parent/guardian of the said child hereby give my consent for my son/daughter to be contacted by phone by his or her connect leader. I understand that the connect leader will speak to me first before speaking to my child so that I am aware of who is speaking with my child. Supervision Policy: Imagine Nations Youth will provide supervision at parent pick-up point at the venue. No child will b allowed to leave the venue until they are picked up by a parent/guardian. It is an essential term of Imagine Nations Youth registration that where parents will not, for any reason, collect their child from the supervised pick up point, then Imagine Nations Youth, its employees, servants and volunteers as organisers of Imagine Nations Youth take no responsibility for any child leaving the supervised site for whatever reason. I understand and agree to be bound by this policy. Privacy Policy: Imagine Nations Church is committed to protect the privacy of an individual's information. Please refer to the Privacy policy on our website.
Text List *
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