Children’s Ministries Registration Form

This information will help in enrolling your child/youth in our programs, to assign them to the appropriate class and to inform you of program updates and upcoming opportunities at our Church. Information received is confidential and is being gathered for the purposes of serving your child(ren) while in the care of Pine Ridge Family Church.

This information will be maintained indefinitely as it is a requirement of our insurance company and legal counsel. If you wish Pine Ridge Family Church to limit the information collected, or to view your child’s information, please contact us.

NAME

ADDRESS

PHONE/MOBILE

CHILD(REN)'S NAME(s) (and Date(s) of Birth)

ALLERGIES? (If so, please list below)

Does your child have any physical, emotional, mental, behavioural concerns or limitations that our staff should be aware of? (If so, please explain)

Is your child bringing any medication with him/her? (If so, please explain)

AUTHORIZATION & MEDICAL CONSENT Any medical information collected here serves to authorize Pine Ridge Family Church, its staff and volunteers, to obtain medical assistance in case of an emergency. In the case of custody agreements, please include the proper form authorizing parental contacts.*By typing "YES" below, I/we, the parents or guardians named above, authorize The Pastoral staff or one of the Pine Ridge Family Church Ministry Staff to sign a consent form for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for the participant named above in the case of any medical emergency.

SIGN IN PROCEDURE We require that children be signed in at the registration desk and signed out at the classroom door at the end of service each week. Your child remains your responsibility until they have been dismissed from the church service to their classroom, and again become your responsibility once you have signed them out at the end of the service.*By typing "YES" below, I/we, the parents or guardians named above, authorize consent for your child, Grade 3 and older to sign themselves out after service.

USE OF PHOTOS *Please indicate, by typing "NO" below if you would NOT LIKE to grant permission for the reasonable use of photos containing your child in service, brochures, newsletters, Church website and/or Facebook.

VOLUNTEERING Family Ministries cannot run without the wonderful help of our volunteers! There are many different ways you can support the babies, children and youth at PRFC. If you would like to know more about how you can help out, let me know and we’ll be in touch.

Is there anything else we should know?

*By typing my name and today's date below, I understand that my electronic signature has the same scope as one provided in writing and that it will be treated in the same way.