Clone of Kids Zone Registration Form

Junior Youth Registration Form

2026/2027 Grades 7 - 9 Wednesdays 7:00-8:30pm
Student Details:
Full Name

First NameLast Name
Birthdate:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Age as of Sept 2026:
Grade as of Sept 2026:
Medical Care Card Number
Medical conditions or extra assistance including all allergies (i.e. bee stings, food items, etc.)
Prescriptions and Instructions: The sponsors will not be handing out medication for your teen, but in an effort to insure your teen is taking their medication on time, any information regarding and medication your teen has to take during a youth function would be helpful.
I give permission for my child named above to attend and participate in Junior Youth sponsored by the North Peace MB Church in the 2026/2027 school year.
I give my consent to have my above mentioned child's pictures used by the church for church related use brochures, website, etc.

Youth Agreement
It is understood that as a youth participating in Junior Youth, I am looking forward to a safe and fun time. Alcohol, non-prescription drugs, cigarettes, vaporizers, e-cigatettes, pornography, fireworks, guns/knives or other dangerouse or harmful items are not allowed. Behavior that may jeopardize my or another's safety is not permitted. Also, it is requested that I refrain from teasing, playing pranks or otherwise speaking or acting in a way that is negative or hurtful towards others. I will listen to and follow the instructions of the sponsors. By signing below I agree to the above statement.
Youth Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

Parent/Guardian Details:
Full Name

First NameLast Name
Phone Number
Format: (000) 000-0000.
E-mail
We use TextInChurch to update parents regarding upcoming events (i.e. change of event time/date/location). Please indicate if you would like to be added to the list. *Note: We clear the list every year. So if you were on the list for the previous year, you will need to be re-added.
Emergency contact (not a parent)

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to child

Liability Release
While every precaution is taken for the safety and good health of the youth, some activities including transportation carry with them the inherent risk of personal injury. Your permission is required to provide this transportation. Please carefully read the following information and consent form.

I give my permission for my youth to participate in Junior Youth activities, both in the church building and including trips away from the church premises. I also give permission for my youth to ride in any vehicle driven by an approved adault chaperone while attending the Junior Youth activities. I understand that SEAT BELTS WILL BE WORN AT ALL TIMES during transportation. I will discuss with my youth that they are to respect each other, the vehicle they ride in, and the people they travel with during the trip; that accidents do happen; that they are to remain in their seats and not be disruptive to the driver of the vehicle.

I/we, the parents or gaurdians named above, undertake and agree to indemnify and hold blameless North Peace MB Church, its personnel, its Directors and Board from and against any loss, damage or injury suffered by the participant as a result of being part of the activities of the group, as well as of any medical treatment authorized by the supervising individuals representing North Peace MB Church. This consent and authorization is effective only when participating in or travelling to events of the North Peace MB Church.
I have read, understood and will comply with the above. Signature:
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

About Junior Youth
Each week we spend time diving into God's word followed by various games and snacks! There is a sign up sheet at the church Welcome Centre or you can all the office @ 250-785-3869 to add your name to the sheet.

Travel: Some of the youth nights may require the use of vehicles to travel to and from different locations. We may also be asking for your help as parents to drive for some of the events. If you plan to help, please contact the church office to ensure your Ciminal Record Check is current or to inform them if you need one. All sponsors and parents who will be active in the Junior Youth ministry MUST have gone through the CRC process. *Note: Any vehicle used for transportating people from the church events must carry a minimum of $2,000,000.00 third party liablity and driver must have a current driver's license, as required by NPMB Insurance Provider

What to bring: A good attitude along with clothes that are appropriate for each event, as we will be outside for some of our events. There may be times when the youth are asked to bring items, depending on what we are doing for an event that week. The youth are encouraged to bring their bibles.

Photographs: At many of our events we take pictures of the youth for use in brouchures and on our website, Instagram and Facebook. If you have any concerns with your youth's picture being used, please feel free to contact the church office.
Should be Empty:

Junior Youth Registration Form

Youth Agreement

Liability Release

About Junior Youth