2017 JOY U Registration
Student Name *
Your answer
Address *
Your answer
Birthday *
Students must be 4 years old by August 1 to attend JOY U. Thank you for your understanding!
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Gender *
Please list any food allergies your child has:
Your answer
Parent(s) Name(s) *
Your answer
Parent Mobile Phone Number (in case of emergency) *
Your answer
Parent email *
Your answer
Select one of the following options: *
If not RCN, where do you attend?
Your answer
Who invited you to JOY U?
Your answer
What grade is your child going into next school year? ('17-'18) *
Please select your 1st choice for a "J" class. *
We will do our best to accommodate your first choice, but need to have your next options in case your first class fills up. If you are a preschooler (4 years old-entering Kindergarten), please choose preschool. :)
Please select your 2nd choice for a "J" class. *
We will do our best to accommodate your first choice, but need to have your next options in case your first class fills up. If you are a preschooler (4 years old-entering Kindergarten), please choose preschool. :)
Please select your 3rd choice for a "J" class. *
We will do our best to accommodate your first choice, but need to have your next options in case your first class fills up. If you are a preschooler (4 years old-entering Kindergarten), please choose preschool. :)
Please select your 1st choice for an "O" class. *
We will do our best to accommodate your first choice, but need to have your next options in case your first class fills up. If you are a preschooler (4 years old-entering Kindergarten), please choose preschool. :)
Please select your 2nd choice for an "O" class. *
We will do our best to accommodate your first choice, but need to have your next options in case your first class fills up. If you are a preschooler (4 years old-entering Kindergarten), please choose preschool. :)
Please select your 3rd choice for an "O" class. *
We will do our best to accommodate your first choice, but need to have your next options in case your first class fills up. If you are a preschooler (4 years old-entering Kindergarten), please choose preschool. :)
Please select your 1st choice for a "Y" class. *
We will do our best to accommodate your first choice, but need to have your next options in case your first class fills up. If you are a preschooler (4 years old-entering Kindergarten), please choose preschool. :)
Please select your 2nd choice for a "Y" class. *
We will do our best to accommodate your first choice, but need to have your next options in case your first class fills up. If you are a preschooler (4 years old-entering Kindergarten), please choose preschool. :)
Please select your 3rd choice for a "Y" class. *
We will do our best to accommodate your first choice, but need to have your next options in case your first class fills up. If you are a preschooler (4 years old-entering Kindergarten), please choose preschool. :)
Medical Release *
The child I am registering in this form has my permission to attend and participate in activities associated with JOY University VBS at Richardson Church of the Nazarene in Richardson, TX. I, the parent/guardian of this minor student do hereby authorize adult workers with children from Richardson Church of the Nazarene of Richardson, TX, agents for undersigned, to consent to any examination, x-ray, anesthetic, medical or surgical diagnosis or treatment and hospital care which is deemed advisable by, and is rendered under the general or special supervision or any physician or surgeon licensed under the provision of the Medical Practice Act on the medical staff or licensed hospital, whatever such diagnosis or treatment is rendered at the office of said physician or at said hospital. I also agree to pay for all charges associated with the care of my child. I knowingly release, absolve, indemnify, and hold harmless Richardson Church of the Nazarene and its agents and employees from all claims that might result from any injury or death of any minor. I/We have read and understand the above statement. By typing your name below we hereby release Richardson Church of the Nazarene of Richardson, Texas from any and all liability for personal injury or damage to property. My typed name below represents my signature.
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