2020-2021 High School Registration

2020-2021 High School Registration

Use this form to register for SNL, Sundays 5:30 - 7:30pm, at the Hecktown Campus (4301 Hecktown Road, Bethlehem) SNL is for 9th - 12th graders. Please bring a chair and a mask. Due to COVID-19 each in-person activity requires parent consent as well as extra safety protocols to ensure the safest possible environment for our students and community. If you or someone in your household is experiencing symptoms of Covid 19 or has been exposed to someone with Covid 19, please remain home as to not spread the virus.
In addition to completion of this registration, the following safety precautions will exist:

-Masks will be worn. -Social Distancing will be practiced
1st Student's Name *

First Name Last Name
Birth Date *

Month Day Year
Date
Grade in 2020-2021 *
Student Email *
example@example.com
Student Cell Phone Number *

Area Code Phone Number
Please list any allergies or special needs/situations:
Second Student's Name

First Name Last Name
Birth Date

Month Day Year
Date
Grade in 2020-21
Student Email
example@example.com
Student Cell Phone Number

Area Code Phone Number
Please list any allergies or special needs/situations:
Third Student's Name

First Name Last Name
Birth Date

Month Day Year
Date
Grade in 2020-21
Student Email
example@example.com
Student Cell Phone Number

Area Code Phone Number
Please list any allergies or special needs/situations:
Parent Covenant/Release: I give my permission for my son/daughter to participate in Grace Students. I release Grace Church, Bethlehem, PA, its trustees, employees, or agents from any liability.

I give permission for photos or video to be taken of my child(ren) during the program or event and to be used for publicity or program purposes (without names attached).

Covid-19 Acknowledgement and release:

GRACE Church Bethlehem has put in place preventative measures to reduce the spread of COVID-19; however, GRACE cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending GRACE events could increase your risk and your child(ren)’s risk of contracting COVID-19.

By signing this release I am stating that 1) My child has not had a fever of 100.4 or higher in the past 14 days. 2) That my child has not been in contact with any individuals known to be infected with COVID-19 in the past 14 days. 3) I acknowledge that COVID-19 is highly contagious and is known to spread mainly from person-to-person contact. By attending, you agree to abide by the procedures established by the church to protect attendees and staff, and you voluntarily assume the risk that you and/or your family may be exposed to or infected by COVID-19. If any of these things change after signing this form I will stay home and let Taylor and Jodi know I cannot attend.
*

I have read and agree to the Parent Covenant/Release
*

I have read and agree to the Covid-19 Acknowledgement and Release
Parent/Guardian #1 Name: *

First Name Last Name
Parent/Guardian #2 Name:

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *

Area Code Phone Number
Email *
example@example.com
Should be Empty:

2020-2021 High School Registration

In addition to completion of this registration, the following safety precautions will exist: