Ruth Alpha-Centauri Pathfinder Registration Form 2020-2021
Pathfinder Club Membership Application
Email *
Child First Name *
Child Last Name *
Date of birth (YYYY/MM/DD) *
Gender *
Child's Phone Number (###) ### - #### (if applicable)
Child's e-mail address (if applicable)
Address *
City *
Province *
Postal *
School Name
Grade Level *
Church
I have been a Pathfinder? *
If yes, from which church?
My dad has been a Pathfinder? *
My mom has been a Pathfinder? *
My dad is a Master Guide? *
My mom is a Master Guide? *
This is to certify that I would like to join the Ruth Alpha-Centauri Pathfinder Club. *
I will attend club meetings, hikes, camping, field trip, missionary adventures and other club activities. *
I will be guided by the rules of the club and the Pathfinder Pledge and Law. *
Pathfinder Signature: By typing your full name below, you agree that all of the information above is accurate to your knowledge. *
Date of Pathfinder Signature (YYYY/MM/DD) *
Parent/Guardian First Name *
Parent/Guardian Last Name *
I am *
Address (if different from above)
Phone Number (###) ### - #### *
Email address:
Parent/Guardian # 2 First Name
Parent/Guardian # 2 Last Name
I am:
Clear selection
Address (if different from above)
Phone Number (###) ### - ###
Email Address:
I/We, the Parent/Guardian, of the child mentioned above, certify that the child is at least in the 5th grade as a Junior Pathfinder, or age 13 as a Teen Pathfinder. *
I/We certify that I/We have read the Pathfinder Pledge and Law and are willing and desirous that the applicant become a Pathfinder. *
I/We will assist the applicant in observing the rules of the Pathfinder organization. *
By signing this form, I/we hereby voluntarily absolve responsibility of the Pathfinder Club and the North American Division Conference of Seventh Day Adventist Church of any accidents or liabilities which many arise in connection to activities of the Pathfinder Club. *
As parents I/we understand that the Pathfinder Club program is an active one for the applicant. It includes many opportunities for service, adventure and fun. I/We will cooperate in the following: *
Required
The following is the 2020-2021 Ruth Alpha-Centauri Membership Fees: New Members: $65.00 Returning Members: $50.00 Kindly indicate below if you are a new or returning member. NOTE: Fees are due by the end of September 2020 for your child to remain a member of the club. Also, fees for uniforms are separate. Kindly speak to the Club Director for more information. *
Please note that while we are hosting Pathfinders via Zoom, the sessions will be recorded for safety measures. Videos will not be used for any promotional purposes. Do you give permission for your child to be recorded? *
During Pathfinder events and trips, there is a possibility that photos and videos may be taken. Kindly select the form of media in which you grant access that your child may participate. Please note that these photos and/or videos may be used in presentations for events such as: Pathfinder Day, Investiture, Church Displays, Church Newsletters, Church Website etc. If at any time you would like this authorization revoked, you may notify the club Director in writing. *
Required
Pickup Permission: Below please select the name(s) of the individual(s) that will have permission to pick up your child when club is finished. For Other - please include the full name and relationship of the individual to your child. Thank You. *
Required
For the purposes of club events and activities, kindly choose which lifestyle choice best describes your child: *
If you are vegan, please select all that applies
If you are vegetarian, please select all that applies (including these animal products)
If you are omnivore*, please select all that applies (including these animal products). *Please note that the club will not prepare or serve some of the options listed below, but we recognize that you may. If we are eating out, we want to know what you approve for your child.
If we are out on a trip, kindly select the fast food restaurant(s) you give permission for your child or the club to purchase from:
Parent/Guardian Signature: By typing your full name below, you agree that all of the information above is accurate to your knowledge. *
Date of Parent/Guardian Signature (YYYY/MM/DD) *
Parent/Guardian # 2 Signature: By typing your full name below, you agree that all of the information above is accurate to your knowledge.
Date of Parent/Guardian Signature (YYYY/MM/DD)
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