Youth Ministries Registration Form

Was your child registered for WFYG in 2023?

YesNo

Has any personal or home information changed (i,e. address, parent phone number, etc.

YesNo

Full Name*

First NameLast Name

Date of Birth*

Age as of Jan. 1, 2024 *

T-Shirt Size

Youth Cell Number

If your child does not have a cell phone please leave this line blank!

Student E-Mail Address

School*

Grade*

I understand that as a Participant in any WFYG activtiy my child may be photographed or videotaped during the activities and I hereby agree to release any and all rights, title, or ownership in such photos/videos. Likewise, I hereby expressly grant permission to Woodlawn Forrest Church of Christ to use any photos/videos of the my Pariticpant in any web site materials.*

I'm ready to go on!*

YesNo

Emergency Contact Name *

First NameLast Name

Emergency Contact Phone Number *

Please enter a valid phone number.

Health Insurance Company

Group Number

Policy Number

Does your child have any chronic or repetitive illnesses?*

YesNo

Please explain any medical condition your child has. This should include any repetitive, chronic illnesses, i.e., asthma, migraine headaches, etc.

Please select all that apply to your child*

Please list what your child is allergic to.

Please explain your child's physical handicap.

Does your child currently take any medications?*

YesNo

Please list each MEDICAL CONDITION - MEDICATION - DOSAGE for your child.

I'm ready to go on!*

YesNo

How many parents will you be entering information for?

123

Parent/Guardian 1*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.

Email

example@example.com

Parent/Guardian 2*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.

Email

example@example.com

Parent/Guardian 3*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.

Email

example@example.com

I give permission for my child to participate in any Woodlawn Forrest Church of Christ event from January 1, 2024 to December 31, 2024.

I, in exchange and consideration for my child’s participation in any and all events and activities planned, organized and/or supervised by Woodlawn Forrest Church of Christ (hereinafter the ‘Activities’), agree to release, defend and hold harmless Woodlawn Forrest Church of Christ (together with all of its staff, ministers, elders, deacons, representatives, employees, volunteers, sponsors (hereinafter ‘Releasees’), from, and against any and all liability, claims, demands, causes of actions of every kind and character, losses, costs, expenses (including attorney fees), and damages of every kind and character for injury or death and damage or alleged damage to any property sustained or alleged to have been sustained arising out of, or related to or incident, to Participant’s participation in the Activities, regardless of whether such claims, demands, causes of action of every kind and character, losses, costs, expenses (including attorney fees), and damages are caused by the sole, joint, or concurrent negligence of Participant. Parent/ Guardian hereby waives and releases any and all claims, demands and causes of action, of every kind and character for personal injury or property damage related to the participation in the Activities of Woodlawn Forrest Church of Christ, Valdosta, GA.

In the event I, the undersigned, as a Parent/ Guardian of the minor Participant listed above, am unable to be contacted in case of a medical emergency, I hereby authorize any staff member and/or adult sponsor who may be supervising or directing any activity sponsored by Woodlawn Forest Church of Christ, Valdosta, GA, to provide, authorize or order emergency medical treatment for the minor Participant listed above while this said Participant is engaged in any activities. I understand that the sponsors will attempt to contact me at the earliest appropriate time concerning such treatment.

I have explained to my minor Participant the attitude and actions expected during the Activities. I expressly understand and agree that, if any Releasee deems it necessary for the Participant to return from any of the Activities due to illness, injury or misconduct, I shall be responsible for all cost associated with such a return trip.

Parent/Guardian Signature*

Youth Ministries Registration Form

Student Personal Info

Student Medical Information

Parent Info

Release of Liability Waiver Agreement