2021/2022 Registration

*Denotes Required Field * Title

Children's Ministries Registration & Consent Form 2021-2022

(Infants through Grade 5)

CHILDREN'S MINISTRIES REGISTRATION

* Child's Last Name

* Child's First Name

* Current Grade

* Birthday

* Age

* Gender

* Address (incl. unit #)

* City

* Province

* Postal Code

* Parent/Guardian 1: Name

* Parent/Guardian 1: Primary Phone Number

Parent/Guardian 1: Secondary Phone Number

Parent/Guardian 2: Name

Parent/Guardian 2: Primary Phone Number

Parent/Guardian 2: Secondary Phone Number

* Household Email

Secondary Email

Please list any allergies or behavioural concerns that our volunteers should know about.

Parent Consent

Information collected on this registration form will be used to connect with you and to keep you up-to-date with programs for kids at Bethany Baptist Church. You can unsubscribe from our mailing list at any time.

Periodically, we will use pictures and videos of our events on our website. Any photos will be used without names.

* I give permission for photos of children's events that may include my child to be used on our church website and in other promotional material.

This consent form gives permission to Bethany Baptist Church to seek whatever medical attention is deemed necessary to treat any injuries or ailments that my child could encounter.

I/We the undersigned have legal custody of the student named above, a minor, and have given our consent for him/her to attend events organized by Bethany Baptist Church. I/We understand that there are inherent risks involved in any ministry or athletic event including, but not limited to the following: Sprained or broken limbs, concussion, bruises, and cuts. In the event that my/our child is injured and requires the attention of a doctor, I/we consent to any reasonable medical treatment as deemed necessary by a licensed physician. In the event treatment is required from a physician and/or hospital personnel designated by Bethany Baptist Church, I/we agree to hold such person free and harmless for any claims, demands, or suits for damages arising from the giving of such consent. I/we also acknowledge that we will be ultimately responsible for the cost of any medical care should the cost of that medical care not be reimbursed by the health insurance provider. Further, I/we affirm that the health insurance information provided above is accurate at this date and will, to the best of my/our knowledge, still be in force for the child named above. I/we also agree to hold harmless and indemnify the releases from any and all liability for any property damage or personal injury to any third party resulting from my child’s participating in the Bethany Baptist Church’s Children's Ministries Program.

* Type Name of Child

* Parent/Guardian Digital Signature (type name here):

* Date Signed: