Soul Revolution (SRV) Registration 2015-2016

538 Spinning Road
Riverside, Oh 45431
Phone (937) 252-5311

Phone (937) 252-5311 Church email: spinroad@sbcglobal.net

At Spinning Road Baptist Church it is important to us that children and adults remain safe and well cared for at all times. In light of this desire, we require that all children and youth who attend events both on our campus and events that will take place or take groups away from our church campus submit the appropriate forms.

Our policy is to have a "Consent and Release of Liability" Form for each participant with phone numbers and pertinent medical information, submitted annually to cover each Year (i.e. September 1 - August 31). For each particular trip or event we also require a specific permission slip with a parent signature, so we can be assured each child has permission to participate in that specific event or trip, and parents know where their children are and what they are doing. All Children & youth are required to have the following completed forms on file:

• Photo/Video Release Form
• Cell Phone Policy
• Youth Code of conduct
• Health Information
• Authorization for Treatment
• Medical Release
• Awana Registration/Medical release form

Before a child/youth may be cleared to participate in an event they must also have a completed and signed off-site permission form. Please be advised that we encourage the youth to invite their friends to join us when we meet. If your child invites a friend to an activity that will take place outside of the church, then we need to have their friend’s parents sign a permission slip. Without the signed permission slip, no child will be taken off church grounds.
Please fill out and return the enclosed form. It will provide our leaders with important information about your child, and contact information where you and/or an emergency contact can be reached in case of an emergency.
This registration form will be maintained on file at the church. If changes need to be made throughout the year, please alert a leader and update the information.
If you have any questions, please don’t hesitate to contact the leadership Team.

    Youth Information

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    Parent / Guardian Information

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    Emergency Contact Information

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    Medical Information

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    Health Information

    If your child should require medical attention for injuries received or illnesses contracted prior to activities with the Spinning Road Baptist Church Youth Group, please send us the necessary information to give him/her proper medical care during his/her time with the youth ministry activities.
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    Medical Release Authorization

    I hereby give permission to the physician selected by SRBC leaders to order X-rays, routine tests and treatment; to release any records necessary for insurance purposes; And to provide or arrange necessary related transportation for my child. I am aware that every precaution will be taken for the safety of my child. In the event of an emergency I will be contacted immediately. If I or my emergency contact person cannot be reached, I hereby authorize the physician selected by SRBC leaders to secure and administer treatment which, in the opinion of the attending physician may endanger his or her life, cause disfigurement, physical impairment, or undue discomfort if delayed, including hospitalization, ambulance transport and paramedics for the above named child. I hereby agree to fully pay all costs of medical or dental care connected with this treatment, and/or incurred by SRBC or their agent. I hereby release Spinning Road Baptist Church, Pastor, volunteers, agents, and vehicle driver of any vehicle driven (if transportation is part of an event) from liability.
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    Photo / Video Release

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    Cell Phone Policy

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    Youth Code of Conduct

    1. I agree to respect the rights, property, and personal space of others. I understand that neither vandalism nor stealing will be tolerated. Financial obligations that result from such behavior will be the sole responsibility of me and my family. 2. I agree to respect adult leaders and other participants at all events, meetings etc. 3. I agree to demonstrate Christian values by my language and behavior. 4. I understand that the following behavior is appropriate conduct. • One armed side hugs • Handshakes • High fives and hand slapping • Verbal praise • Arms around shoulders • Hold hands during prayer only 5. I understand that the following behaviors are samples of inappropriate conduct. Please note that this list is not exhaustive. • Kissing • Inappropriate touching • Verbal sarcasm • Massages of any kind • Any form of unwanted affection • Compliments that relate to a youth's body. 6. I agree not to possess any drugs, tobacco, alcohol, fireworks, matches, cigarette lighters, knives, or items that would endanger people, pets, wildlife, or property or are illegal. 7. I agree to dress appropriately. I understand that this prohibits short shorts, tank tops, any clothing that has any reference to tobacco or alcohol products including insignias or advertisements. 8. I will act as a lady or gentleman and refrain from any sexual misconduct. 9. I will not leave an event/meeting, unless my adult leader grants permission. 10. I will not bring radios, boom boxes, CD players, I Pods, mp3 players, and video games to an event/meeting, unless otherwise noted by leaders. 11. I will be open to building new relationships with my peers and adult leaders. I understand the need to agree to the above items. I realize and agree that if I do not abide by these rules, I may lose the privilege of attending a scheduled activity, or may be sent home at the discretion of the adult leader. I will be responsible for all consequences of my behavior.
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    After you submit this form:

    Please see one of the Youth Leaders to sign a paper copy for our records.