Youth Group Registration Form

Parent/ Guardian Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Parent or guardian email*

Phone Number of parent or gaurdian*

Area CodePhone Number

Emergency contact's name*

First NameLast Name

Emergency contact number *

Area CodePhone Number

Emergency contacts relation to youth

Are you part of a Faith community?*

Youth's name*

First NameLast Name

Grade*

Youth's Birthday *

Date

Allergies/ Medical Concerns

Health card No. (optional)

Second Child's name (optional)

Child's Birthday

Date

Allergies/ Medical Concerns

Health card No. (optional)

Yes, you can use my child's photoYes, you can use my child's photo, but do not include a namePlease do not take my child's photoOther

This consent/waiver form is a general consent for the year of September 2025 – August 2026. In the event of an overnight activity, a separate consent form will be sent home with specific information. Youth will not be allowed to participate in youth events that are off-site unless this consent form is completed.

I am aware that medical officials can authorize emergency medical care that is required should the need arise. This would apply only when a serious condition exists and Westview Baptist Church youth leaders and medical officials have been unable to contact the parents/guardians. Precautions are taken for the safety and health of your child, but in the event of accident or sickness, Westview Baptist Church, its staff and volunteers are hereby released from any liability.

Please type "yes" if you have read and agree to the above statement.*

yesOther

yesnoOther

yesno

Please add any other important information or questions regarding your child in this section

Youth Group Registration form