Primary Contact Information
Please note: This form is intended to be completed by a parent or legal guardian. If the participant is 18 years of age or older, they may complete this form themselves and are responsible for ensuring all information provided is accurate and complete.
Parent/Guardian
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
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Emergency Contact
Is the emergency contact the same as the primary contact?
Yes
No
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
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Registrant(s) Information
Simply fill out the details for your first attendee, and then click the 'Add Another Registrant' button to add more students or guests to your group.
Registrant Information
*
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Medical Disclosure & First Aid Consent
By selecting below, you confirm that all relevant medical conditions, allergies, and health concerns have been fully disclosed in this registration. Youth leaders do not collect, store, or administer prescription medication. Students are responsible for safely storing and administering their own medication. Under no circumstances may students share prescription or non-prescription medication. Leaders will have a basic first aid kit available, including bandages, antibacterial treatment, and ibuprofen if needed. In the event of illness or injury, leaders may provide basic first aid and seek appropriate medical attention if necessary.
*
I agree to the Medical Disclosure & First Aid terms.
I do NOT agree to the Medical Disclosure & First Aid terms. I understand that my teen will not be permitted to attend the retreat.
Behavioral Expectations & Phone Policy
Students are expected to follow the instructions of leaders and behave in a manner consistent with the values of the Calgary Church of Christ. These guidelines are in place for the safety and well-being of all participants.Phones are not permitted during daytime programming due to distraction. Students may access their phones in the cabins during designated times. Youth leaders will remain accessible at all times.If a student refuses to follow expectations, behaves in a way that compromises safety, or is otherwise non-compliant, a parent or guardian will be contacted and may be required to arrange prompt transportation to pick up their teen at their own expense.
*
I agree to the Behavioral Expectations & Phone Policy.
I do NOT agree to the Behavioral Expectations & Phone Policy. I understand that my teen will not be permitted to attend the retreat.
Media & Photography Release
A designated photographer will be present during the retreat. Photos and videos may be used by the Calgary Church of Christ for church-related purposes including: Instagram (@ignitecofc)Church website Church newsletters Slideshows or presentations such as the Grad Banquet Other church communications Students are also permitted to take photos during the retreat for appropriate use on our youth Instagram account (@ignitecofc). While expectations will be set, the church cannot completely prevent students from taking personal photos.
*
I give permission for my teen to appear in photos or videos used by the Calgary Church of Christ.
I do NOT give permission for my teen to appear in church photos or media related to this event.
Waiver Signature
By signing below, I confirm that I am the parent or legal guardian of the minor listed in this registration. I certify that all information provided in this form is true and complete to the best of my knowledge. I acknowledge that I have read and understand all sections of this registration, including the Authorization & Travel, Medical Disclosure, Behavioral Expectations, and Media Release sections. I understand that my selections above indicate my agreement or non-agreement to each section. By signing, I confirm my agreement to the applicable terms and give permission for my teen to participate in the Fire & Ice Retreat in accordance with the selections made above.
*
Submit
Submit
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