The Community Youth Registration Form 2021/2022

Parent/ Guardian Information

First Parent/Guardian Full Name

Cell Phone

This address will receive a confirmation email

Address

Secondary Parent/Guardian Full Name

Cell Phone

We send out monthly emails with ALL the details you need for events coming up.

We will also send short reminder texts each week.

**Emails and Texts will go to the email and number listed under the first parent/guardian email and cell number.**

Please Send Us:

Student Information

First Student Name

Alberta Health Care Number

Gender

Birthday

Name Of School

Grade

Allergies, Medication Taken, Or Other Health Concerns A Leader Should Be Aware Of During Youth

Second Student Name

Alberta Health Care Number

Gender

Birthday

Name Of School

Grade

Allergies, Medication Taken, Or Other Health Concerns A Leader Should Be Aware Of During Youth

Third Student Name

Alberta Health Care Number

Gender

Birthday

Phone

Name Of School

Grade

Allergies, Medication Taken, Or Other Health Concerns A Leader Should Be Aware Of During Youth

Emergency Contact

Primary Emergency Contact

Primary Emergency Contact Phone

Relationship To Student

Secondary Emergency Contact

Secondary Emergency Contact Phone

Relationship To Student

Family Doctor

Consents

Medical Consent - In the event of an emergency and medical treatment is required, I give permission to the church staff and/or to volunteer leaders to obtain services for treatment as deemed necessary if I cannot be contacted in a reasonable amount of time. Further, I will hold harmless or indemnify Spruce Grove Community Church for any loss or injury that may be sustained. I recognize that there are risks inherent in activities my child may be engaged in and again, I waive, hold harmless, or indemnify Spruce Grove Community Church, paid or volunteer staff, successors, heirs and assigns from action.

I give permission for my child to be photographed and/or filmed without any reimbursement of any kind due me, or the need to pay any fee. Spruce Grove Community Church considers all information to be personal and confidential, and will only use it within the church for ministry or other church-related activities, on the website, in print, and on our Facebook and Instagram accounts. We will not release photos or videos to outside parties or organizations. Valid September 1, 2021 - August 31, 2022

Off- Site Permission - I hereby give permission for my child to participate in off-site events between September 1, 2021 and August 31, 2022. I give authorization for staff and volunteer leaders of Spruce Grove Community Church to obtain necessary medical treatment as needed while off-site. I assume responsibility for any medical bills incurred, and should my child be required to return home before the group for medical or disciplinary reasons, I also hereby assume any costs incurred. I give authorization for SGCC staff or volunteer leaders to provide all necessary food, transportation, and lodging as applicable. I do hereby release, forever discharge and agree to hold harmless SGCC and its representatives thereof from any and all liability claims or demands for personal injury, sickness or death. As well as property damage and expenses of any nature, which may be incurred by my child in the course of participation in off-site activities. Furthermore, I agree to assume all responsibility for any of the previous mentioned occurrences.

Transportation Waiver - Knowing that all precautions have been taken for the safety and health of my youth(s), some activities including transportation carry with them the inherent risk of personal injury. I give permission for my child to be transported in a motor vehicle driven by an SGCC approved staff or youth leader to any/all youth events of September 1, 2021 to August 31, 2022. I understand that my child is required to follow all applicable laws regarding riding in a motor vehicle and is to follow all rules set out by the drivers of the vehicles. I will not hold SGCC, staff or volunteers responsible and do indemnify them of any loss, damage or injury suffered by the participant.

Full Name

The Community Youth Registration Form 2021/2022

Description

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