Bethesda Kids Church 2023/2024

Bethesda Kids Church 2023/2024

Registration
Child's Name

First NameLast Name
Gender
Date of Birth

MonthDayYear
Date
MCP Number
MCP Expiry
Allergies
IN CASE OF EMERGENCY CONTACT

First and Last NamePhone Number
Does your Child have any physical, emotional, mental, behavioural concerns or limitations that staff should be aware of?
Parent/Guardian Name

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
Would you like to subscribe to the Bethesda Kids mailing list

YesNo
Parent Signature

Please sign below
As the parent/guardian of the student noted in this form, I am providing my signature as permission for them to attend in-person gatherings at Bethesda Kids Church (a ministry of Bethesda Pentecostal Church). I acknowledge that there are regulations that they're expected to follow and the importance of my partnering with Bethesda Kids Church in ensuring my child is compliant with these regulations. If my child isn't compliant or is negligent in adhering to the rules and current guidelines, or exhibits signs of illness, I may be called and asked to pick my student up early.
Signature

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Media Release

Please sign below
Please sign below to grant permission for the reasonable use of pictures containing your Child in any or all of the following ways: Brochures/Promotional material, Church Website/Social Media, Newsletters, Videotaping, Recording, Live-Streaming.
Signature

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Medical Release & Purposes and Intent

Please sign below
MEDICAL RELEASE

The safety of your Child is our primary concern. Precautions will be taken for their well-being and protection. I/we, the Parents or guardians named below, authorize a pastor of Bethesda Pentecostal Church or one of Bethesda Kids Church (a ministry of Bethesda Pentecostal Church) 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, Bethesda Kids Church (a ministry of Bethesda Pentecostal Church), 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 Bethesda Kids Church (a ministry of Bethesda Pentecostal Church), as well as of any medical treatment authorized by the supervising individuals representing Bethesda Kids Church (a ministry of Bethesda Pentecostal Church). This consent and authorization is effective only when participating in or traveling to events sponsored by Bethesda Kids Church (a ministry of Bethesda Pentecostal Church).

PURPOSES AND EXTENT

Bethesda Kids Church (a ministry of Bethesda Pentecostal Church) 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 Bethesda Kids Church (a ministry of Bethesda Pentecostal Church). This information will be maintained indefinitely as it is a requirement of our insurance company and legal counsel. If you wish Bethesda Kids Church (a ministry of Bethesda Pentecostal Church)to limit the information collected, or to view your Child’s information, please contact us. I have read, understood and agree with the above.
Signature

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Should be Empty:

Bethesda Kids Church 2023/2024

Parent Signature

Media Release

Medical Release & Purposes and Intent