Youth Alpha Registration

Youth Alpha Registration

Complete this form to register—participants under 18 require a parent/guardian to complete the consent section.
For Youths Grades 7-12.

Find out more about Youth Alpha: https://youtu.be/9WntrUJ0AV0?feature=shared

Alpha Youth Sessions will take place every other Friday, beginning on October 16, 2026, at 7:00pm. Location will be at St. Bonaventure Catholic School (Gym) at 1340 Leslie St, North York, ON. Snacks and drinks will be provided. But most importantly, come with a ready heart and mind and ready to have fun!

Session Dates for 2026:

- October 16 and 30, 2026
- November 13 and 27, 2026
- December 11, 2026 (Last one for the year and Christmas party!)
Participant Information
Participant Full Name

First NameMiddle NameLast Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Age
Current School Grade
Gender
Participant Email
example@example.com
Participant Phone
Please enter a valid phone number.Format: (000) 000-0000.
Home Address

Street Address

Street Address Line 2
CityProvincePostal Code
Parent/Guardian Information
Parent/Guardian Full Name

First NameMiddle NameLast Name
Relationship to Participant
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Second Parent/Guardian Name

First NameMiddle NameLast Name
Second Parent/Guardian Phone
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact
Emergency Contact Name

First NameLast Name
Health & Dietary
Does the participant have any allergies, including food allergies?
If yes, please describe the allergies
Dietary restrictions or food preferences
Getting to Know You
How did you hear about Youth Alpha?
Anything else leaders should know?
Communication Permissions

A policy is in effect that communication is to be used solely for the dissemination of information. Please indicate how Youth Ministry Personnel (staff and volunteers) may communicate with your child:
How may Youth Ministry Personnel communicate with your child?
Consent
Parent/Guardian Consent
I/We, the parents or guardians named above, authorize the Ministry Personnel of The Change Community Church 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.
Release and Indemnity

I/We, named above, undertake, and agree to indemnify and hold blameless the Ministry Personnel, The Change Community Church, its Church Leadership 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 Change Community Church as well as of any medical treatment authorized by the supervising individuals representing the church. This consent and authorization is effective only when participating in or traveling to events of The Change Community Church.
I have read, understood and agree with the above and sign it to cover all Youth Program activities for the program year. I understand a separate Letter of Informed Consent will be sent home for off-site activities and activities of elevated risk.
Parent/Guardian Printed Name
Parent/Guardian E-Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Youth Alpha Registration

For Youths Grades 7-12.

Participant Information

Parent/Guardian Information

Emergency Contact

Health & Dietary

Getting to Know You

Communication Permissions

Consent