26-27 SD FIL-AM Adventurer club registration

San Diego Fil-AM Adventurer club 2026-2027

Registration form for ages 3-9 years old (preschool to fourth grade)
How many children are you registering?
Child Information
First Child
Registration type
Child's Name

First NameLast Name
Optional: Please list if your child has a different preferred name or nickname
Child's Birth Date

MonthDayYear
2026-27 school grade
Gender
Shirt size
Primary care doctor and phone number
Medical insurance/health coverage
Medical insurance plan number
Preferred hospital
Please list any food or medication allergies including reaction (ie: amoxicillin causes rash, peanuts cause hives)
Please list any prescription medications and what they are prescribed for. Please include medication strength and frequency
If applicable, please list any food or diet restrictions such as vegetarian, vegan
Second Child
Registration type
Child's Name

First NameLast Name
Optional: Please list if your child has a different preferred name or nickname
Child's Birth Date

MonthDayYear
Gender
2026-27 school grade
Shirt size
Primary care doctor and phone number
Medical insurance/health coverage
Medical insurance plan number
Preferred hospital
Please list any food or medication allergies including reaction (ie: amoxicillin causes rash, peanuts cause hives)
Please list any prescription medications and what they are prescribed for. Please include medication strength and frequency
If applicable, please list any food or diet restrictions such as vegetarian, vegan
Third Child
Registration type
Child's Name

First NameLast Name
Optional: Please list if your child has a different preferred name or nickname
Child's Birth Date

MonthDayYear
Gender
2026-27 school grade
Shirt size
Primary care doctor and phone number
Medical insurance/health coverage
Medical insurance plan number
Preferred hospital
Please list any food or medication allergies including reaction (ie: amoxicillin causes rash, peanuts cause hives)
Please list any prescription medications and what they are prescribed for. Please include medication strength and frequency
If applicable, please list any food or diet restrictions such as vegetarian, vegan
Fourth Child
Registration type
Child's Name

First NameLast Name
Optional: Please list if your child has a different preferred name or nickname
Child's Birth Date

MonthDayYear
Gender
2026-27 school grade
Shirt size
Primary care doctor and phone number
Medical insurance/health coverage
Medical insurance plan number
Preferred hospital
Please list any food or medication allergies including reaction (ie: amoxicillin causes rash, peanuts cause hives)
Please list any prescription medications and what they are prescribed for. Please include medication strength and frequency
If applicable, please list any food or diet restrictions such as vegetarian, vegan
To help us develop your child’s/children's spiritual growth, please list their interests (ie: singing, speaking on stage, drill)
Please indicate if payment was made; cash or check to San Diego Fil-AM (check memo: Adventurer registration)
- Parent/guardian Information
- Parent/Legal Guardian Name
  
  First NameLast Name
- Phone Number
  
  Area CodePhone Number
- Birth Date
  
  MonthDayYear
- Email
  example@example.com
- Approx date/year of AB506 (live scan for SECC conference specifically; put N/A if not yet completed)
- Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- Would you like to receive text messages and/or email reminders and announcements?
- Second parent or guardian name
  
  First NameLast Name
- Phone Number
  
  Area CodePhone Number
- Birth Date
  
  MonthDayYear
- Email
  example@example.com
- Approx date/year of AB506 (live scan for SECC conference specifically; put N/A if not yet completed)
- Address (if different than above)
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Please list the name and phone number of others who are authorized to pick up your child/children
- Media Release
- I, the undersigned parent/guardian, grant permission for my child/children to be photographed and/or recorded (audio/video) during adventurer club activities, events, rehearsals, and programs.
  
  I understand that these photos and videos may be used by the Adventurer club and affiliated organization for purposes including but not limited to:
  
  Church presentations and services
  
  Social media posts (e.g. Facebook, Instagram, YouTube)
  
  Promotional materials (flyers, posters, videos)
  
  Internal documentation and archives
  
  I understand that my child's/children's name may or may not be included with the media. The media will be used in a respectful and appropriate manner. The club reserves the right to modify, reproduce, and distribute media for official purposes only.
  
  I release and hold harmless the San Diego Fil-AM club, its leaders, and affiliated organization from any claim related to the use of my child's/children's image or likeness as described above.
  
  I confirm that I am a legal parent/guardian of the child/children and have the authority to grant this consent
- Please list children’s names
- Date
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearDate
- Signature
Should be Empty: