Gods Royal Assembly

Youth

God’s Royal Assembly youth Registration form

This form is to be completed when a child or young person first joins or is there but has not sign a membership form for the children’s or youth ministry program. It is reviewed at the beginning of each year. Completed forms are retained by the Church and the youth pastor and kept in a locket cabinet and are used occasionally for camping purposes. The Leader of Children’s ministry should have access to the form in case of emergency.

How many children are you registering?

Child / Children Information

Child's Name

Child's Birth Date

Last Year Completed

Does the child attend Sunday school anywhere?

Yes

No

Medical or other information we may need to know about the child (including food allergies).

Child Release Information

Parent/Legal Guardian Name

Phone Number

Address

Names of Persons to which the child (children) may be released to each night after VBS (Please provide at least two)

Full Name

Are there any persons to which the child (children) may NOT be released to?

Yes

No

Emergency Contact 1 (other than parent/guardian listed above)

Emergency Contact 1 Phone Number

Emergency Contact 2 (other than parent/guardian listed above)

Emergency Contact 2 Phone Number

Media Release

By clicking the box below, I hereby Give Permission for photographs and/or video in which my child appears in to be used by the church in printed and/or electronic media, including the church's website.

I Agree

Youth