2024-2025 Bible Club & Youth Registration and Permission Form

First Presbyterian Church offers to its members, guests and community, a variety of opportunities to participate in Kids Ministry. These activities may include field trips, recreation, service projects, etc. When working with children, permission is needed for your child to participate in our program and activities and we often require parents to complete and sign several forms for each event. In an effort to save time, repetition and paperwork, we ask that you complete the following online form generated through Breeze, our church information system, about emergency contacts, medical concerns, and health insurance. This form should allow us to gather the needed information with only your signature needed to verify that the information is current and to give your consent for participation. If you do not wish to complete the online form, a paper copy option will be available for you.

Child Information

Child's Full Name

Name Called By

Date of Birth

Age as of Sept 1, 2024

Medical Concerns: Please list any Medical Conditions/Allergies/Dietary Restrictions relevant to participation. (foods, insects, etc)

Medication: Please list any medications the child may need to take that we should know about. Include information about administration of the medication.

Medical Insurance Provider/Company covering the child

Medical Insurance Policy Number

Any special tips or concerns that will help us as we work with you child

Parent/Guardian Contact Information

Home Address

Home Phone

Parent/Legal Guardian 1

Parent/Legal Guardian 1 Mobile Phone Number

Parent/Legal Guardian 1 Email

This address will receive a confirmation email

Parent/Legal Guardian 2

Parent/Legal Guardian 2 Mobile Phone Number

Parent/Legal Guardian 2 Email

This address will receive a confirmation email

Alternate Emergency Contact (in the event a parent can not be reached)

Alternate Emergency Phone Number

Alternate Contact's Relationship to Child

Joy Gift

If your child is in Kindergarten - 5th grade, will they participate in Joy Gift? More Information about Joy Gift will be available in September and practice will begin in November.

Permissions and Agreements

Bible Club at First Presbyterian Church of Dunn may include Bible Study, Catechism, Music, Crafts, Service Projects, Exploration Activities, and Recreation/Games. Recreation may take place outdoor or indoors, weather permitting. Occasionally, Kid and/or Youth Fellowship may involve off-campus transportation. There will be separate permission forms generated for these events which will require parent signature.

Permission to Participate

I give my child/youth permission to participate in all Kid's/Youth Fellowship activities I have concerns about my child's participation in activities specified below. I will communicate with the Director about these concerns.

Specify participation concerns below.

On occasion, First Presbyterian Church publishes or posts photos or videos of church activities and events in order to demonstrate and publicize the ongoing activities of our church. These photos/videos may include images of groups or individuals participating in these events as well as their work products such as but not limited to crafts or artwork being produced during the event. This form requests your permission as parent/guardian to post your minor child’s likeness and/or work products such as crafts and artwork on our church bulletin boards, directories, website, Facebook page, newsletter and/or in any local newspaper, etc.. In order to protect the safety of your child, his/her identifying information will not be posted with the picture. For the purpose of this form, a minor child is defined as any person of less than 18 years of age.

Permission to publish the image or likeness of a minor.

I give my permission to First Presbyterian Church to publish or post the image or likeness of my child. I do not give my permission to First Presbyterian Church to publish or post the image or likeness of my child.

Permission to publish/post the creative work products of a minor

I give permission to the First Presbyterian Church of Dunn to publish/post my minor child's original/creative work products on the church website, church newsletter, church Facebook page, church bulletin board, other church publications, local newspaper, I do not give permission to the First Presbyterian Church of Dunn to publish/post my minor child's original/creative work products on the church website, church newsletter, church Facebook page, church bulletin board, other church publications, local news

Electronic signature: I acknowledge that by typing my full name in this space provided that it will be recorded as a timestamped signature once it is submitted. This also serves to confirm that I am a legal parent or guardian of the minor child registered on this form and that I agree to the above permissions that I have selected.

2024-2025 Bible Club & Youth Registration and Permission Form

Description

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