Student Registration

First

Middle

Gender:

MaleFemale

Last

Birth Date

Date

Age

Street Address

TownCity

State

Zip code

Phone

School Name

Grade 2023-2024 school year

Parent/Guardian - Contact Information

Parent/Guardian #1

First

Last

Street Address

TownCity

State

Zip Code

Phone

Work Phone

Email

example@example.com

Parent/Guardian #2

First

Last

Street Address

TownCity

State

Zip Code

Phone

Work Phone

Email

example@example.com

Emergency Contact Information - Alternate Pickup/Release Emergency Contact #1 (Please print)

First

Last

Home/Cell Phone

Work Phone

Email

example@example.com

Relation to child

Emergency Contact #2 (Please print)

First Name

Last

Home/Cell Phone

Work Phone

Email

example@example.com

Relation to Child

Please complete the attached documents:

1. Medical Questionnaire

2. Video Release Form

3. Code of Conduct

4. Minor Waiver

5. Statement of Faith & Worker's Compliance Form

Deposit/Tuition for CYIA Training & Payment Policies:

Three levels at Christian Youth In Action Training school. Our goal is to equip teams of young people to go out and teach 5-Day Clubs.

1st Jr-CYIA, for first time and younger students, a training school notebook and Tee shirts. During the summer clubs will be assisting Missions and Bible teachers in the 5-Day Clubs. Will focus on "How to lead a Child to Christ", motions for the songs and helping with games.

Jr-CYIA tuition $75.00: $25.00 registration due with application by May 15th, remainder $50.00 due June 1st.

2nd Missions teacher, returning and older students, will receive a training school notebook, Tee shirts and a 5-Day Club kit. Responsibilities: Along with everything the Jr-CYIA does, they will be prepared to teach the Memory verses, Review Games, Word up and the missions story.

Mission teacher tuition $150.00: $50.00 registration due with application by May 15th, remainder $100.00 due June 1st.

3rd Bible teacher, returning missions student, will receive a training school notebook, Tee shirts and a 5-Day Club kit. Responsibilities: Along with everything the Missions teacher can do they will be prepared to teach the Bible Lesson, and able to lead club, including High Octane games.

Bible teacher tuition $150.00 : $50.00 registration due with application by May 15th, remainder $100.00 due June 1st.

I am registering for:

Jr-CYIAMissions TeacherBible Teacher

CYIA Training Participant Agreement

I, the undersigned parent, hereby release discharge, indemnify, hold harmless, and defend CEF of IDAHO, its officers, employees, and servants from any and all liability (claims, demands, losses, causes of action, suits, judgments) of any kind that I or my family may have against District due to death, personal injury or illness, loss or damage to property, or future causes that occur during the CEF OF IDAHO TRAINING. In the event of any medical emergency, I authorize and consent to act on my behalf for medical care deemed necessary for the participant.

I, the undersigned student, have read and understand the CYIA Code of Conduct. I agree to follow this Code as I participate at CYIA and in other CEF activities.

Applicant Name please print

Applicant Signature

Date

ParentGuardian Name please print

ParentGuardian Signature

Date