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J.A.M. Sign Up
Cedar Grove Brethren in Christ Church is proud to serve the students of Juniata County School District by offering J.A.M. to all students in grades K-5 for the upcoming 2025-2026 school year. What is J.A.M. you ask? J.A.M., while standing for Jesus and Me, is a FREE program offered on Teacher In-Service days where students are provided a safe place to hang out, play games, and fellowship with classmates while parents may be at work and school is not in session. A light breakfast and lunch will be provided at no cost to all those who attend. Transportation from J.E.S. will be provided for students who typically walk to school, or students can be conveniently dropped off and picked up at Cedar Grove BIC. Cedar Grove is located off the Port Royal exit at 287 Deerville Rd, Mifflintown, PA 17059. Please complete a separate form for each child you wish to register. We can't wait to J.A.M. with you! 
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Email *
Which days would you like to register your child for J.A.M.? You may select multiple  *
Required
What is your Child's Name (First, Last)? *
What grade is your child in for the 2025-2026 School year? *
What school does your child currently attend? *
Parent/Guardian Name: *
Parent/Guardian Phone Number: *
Emergency Contact: *
Emergency Contact Number: *
Emergency Contact Relationship to Child: *
Does your child have any allergies or medical conditions we should be aware of?
What method of transportation will your child be utilizing? *
I herby consent to the participation of my child and understand that Cedar Grove B.I.C. and Juniata County School District shall not be held liable. I understand that although the students will be supervised, I do assume the risk in my student’s participation in the event.

I acknowledge that I will not seek to have the School District or Cedar Grove B.I.C. held liable in the event that any accident, injury, loss of property or any other circumstance or incident occurs during or as a result of my son’s/daughter’s participation in J.A.M. Act 80 day programs. This release of liability includes accident, injury, loss, or damages to the student, as well as, to other individuals or property which may result from the student’s participation in the event. I hereby release and agree to hold harmless the School District and Church, its officials, agents and employees, from any claims arising out of my son’s/daughter’s participation in the event(s).

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Parent Signature *
Date *
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A copy of your responses will be emailed to the address you provided.
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