Bayview Youth Registration
Students in grades 6-12 in the 2024-25 school year
Student Information:
Name
*
First Name
Last Name
Birthdate
*
-
Month
-
Day
Year
Date Picker Icon
Current Grade
Please Select
JH -Grade 6
JH - Grade 7
JH - Grade 8
YTH - Grade 9
YTH - Grade 10
YTH - Grade 11
YTH - Grade 12
Student Email
*
example@example.com
Student Number (if applicable)
Please enter a valid phone number.
Parent Email for communications
*
example@example.com
Parent Number
*
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact
*
First Name
Last Name
Emergency Contacts Phone Number if different from parent number above
Allergies (Food/Seasonal etc) or Behavioural Concerns/Accomodations
Please indicate what they are
Is there anything else you would like us to know?
Informed Consent and Acknowledgement: In the event I cannot be reached in an emergency, I/We the parents or guardians named above hereby give my permission to the medical personnel selected by the Bayview Glen Church Ministry staff to secure emergency medical treatment including but not limited to, first aid, CPR, admission to any hospital, tests, surgery or general anaesthesia. I/We, named above, undertake and agree to indemnify and hold blameless Bayview Glen Church, its Pastors and Board of Directors from and against any loss, damage or injury suffered by the participant as a result of being part of the activities of Bayview Glen Church. This consent and authorization is effective only when participating in or traveling to/from events of the Bayview Glen Church. I/ We understand that electronic devices are not allowed during programs. However pictures may be taken at designated times and events by participants. Photos or videos taken for church purpose/ promotion will never be published with names (unless parental permission is obtained). I/ We understand that the information being collected may be used for mail and electronic communication purposes ONLY by Bayview Glen Church. Information will never be given to a third-party.
Parent/Gaurdian - I acknowledge and agree to the above and by and entering my name below, I am delivering an electronic signature that will have the same effect as an original manual paper signature. The electronic signature will be equally as binding as an original manual paper signature.
I am age 16+ and agree to the above and by and entering my name below, I am delivering an electronic signature that will have the same effect as an original manual paper signature. The electronic signature will be equally as binding as an original manual paper signature.
Name of Parent/Guardian or Student age 16+
First Name
Last Name
Signature
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