Evangel Kids Registration Form for school year of 2022-2023

Children's Ministry Registration and Consent Form

Information received is confidential and is being gathered for the purposes of serving your Child while in the care of Pentecostal Assemblies of Newfoundland and Labrador. Any medical information collected here serves to authorize Pentecostal Assemblies of Newfoundland andLabrador, and its staff and volunteers, to obtain medical assistance in emergencies.

In the case of custody agreements, please include the proper form authorizing Parental contacts.

I am registering my child to participate in the following ministries:

Sprouts - Age 3 to Kindergarten. Sprouts takes place during the Sunday AM Service. Vine - Grades 1-6. Vine takes place during the Sunday AM Service. Roots - Ages 3 to Grade 6. Roots take place 9:45-10:45AM Sunday Mornings.

Child's Name

Date of Birth

Date

Child's Grade

Address

Phone Number

Parents' Work Number

Email

example@example.com

MCP Number

Family Doctor

Phone Number

Allergies

In case of an emergency, contact

Does your Child have any physical, emotional, mental, behavioural concerns or limitations that staff should be aware of?

Yes No

If yes, please explain

Is your Child bringing any medication with him/her?

Yes No

If yes, please list.

The safety of your Child is our primary concern. Precautions will betaken for their well-being and protection.

I/we, the Parents or guardians named below, authorize the program leaders or one of Pentecostal Assemblies of Newfoundland and Labrador Program Personnel to sign a consent for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for the participant named above.

I/we, named below, undertake and agree to indemnify and hold harmless Program Personnel, Pentecostal Assemblies of Newfoundland and Labrador, and its Leaders from and against any loss, damage or injury suffered by the participant as a result of being part of the activities of Pentecostal Assemblies of Newfoundland and Labrador, as well as of any medical treatment authorized by the supervising individuals representing the Pentecostal Assemblies of Newfoundland and Labrador. This consent and authorization is effective only when participating in or traveling to events sponsored by Pentecostal Assemblies of Newfoundland

Kids will be checked in at the Kids desk in the foyer, and kids aged grade 2 and younger must also be signed out of their classrooms. All other age groups will be released at end time without sign-out.

Brochures/Promotional material Please sign below to grant permission for the reasonable use of pictures containing your Child in any or all of the following ways:

Church Website Newsletters Videotaping

Pentecostal Assemblies of Newfoundland and Labrador is collecting and retaining this personal information for the purpose of enrolling your Child in our programs, to assign the student to the appropriate classes, to develop and nurture ongoing relationships with you and your Child, and to inform you of program updates and upcoming opportunities at our Pentecostal Assemblies of Newfoundland and Labrador. This information will be maintained indefinitely as it is a requirement of our insurance company and legal counsel. If you wish Pentecostal Assemblies of Newfoundland and Labrador to limit the information collected, or to view your Child's information, please contact us.

I have read, understood and agree with the above.

Parent Signature

Clear

Signature & Printed Name

Date