Spring Park 2018/19 Youth Registration
Please fill out the following form for each child you want to register
Registering for *
Required
Child's name *
Your answer
Date of Birth *
(DD/MM/YY)
Your answer
School and Grade *
Your answer
Date of Baptism
(DD/MM/YY)
Your answer
Guardian's names *
parent's or guardians who have permission to accompany or pick up children
Your answer
Address: *
Your answer
Postal Code *
Your answer
Phone Number *
Your answer
Email(s)
For parents and/ or youth
Your answer
Allergies
(If applicable)
Your answer
Other siblings attending church school
(If applicable)
Your answer
Emergency contact during church school hour:
If the church is in need of the following area, give me a call: *
Required
Is there any other information we should know?
(example: allergies, behavioral issues)
Your answer
Photo release *
Spring Park in addition to its existing promotional materials, is currently running a webpage. Included on this page may be photo albums of the children participating in various activities. Pictures may be taken, or recordings may be made. Please advise us if you are willing to have your child’s/ward’s photograph or voice used in Spring Park indicated below: I, on behalf of my child/ward, give permission to Island Presbytery to photograph and/or record my child/ward or my child’s/ward’s voice on still photographs, motion picture film, audio tape and/or video tape and to use this material, in whole or in part, through the media of television, film, Internet, multi-media presentation, radio, audiotape, videotape or in printed form or display form for the promotion of Island Presbytery, on my behalf of my child/ward assign and transfer to Island Presbytery any and all rights, including copyright, which I may have or my child/ward may have in this material.
Required
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This form was created inside of Spring Park United Church.