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VAPC Youth Program Registration
Youth Group and Sunday School
2020-2021
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* Indicates required question
Youth Information
Youth Name
*
Your answer
Age:
*
Choose
11
12
13
14
15
16
17
18
Address:
*
Your answer
Youth Phone Number:
Your answer
Youth Email Address:
Your answer
School:
*
Your answer
Grade
*
Choose
6
7
8
9
10
11
12
Birthdate
*
MM
/
DD
/
YYYY
Please list interests, talents and activities you are involved in:
*
Your answer
Parent/Guardian Name(s):
*
Your answer
Parent Email Address(es):
*
Your answer
Parent Phone Number(s):
*
Your answer
Emergency Contact (Name and Number):
*
Your answer
AB Health Care Number:
*
Your answer
Special Needs/Allergies/Medical:
*
Your answer
Family Physician (Name and Number):
*
Your answer
[Parent/Guardian] I agree to providing this information about my child (sign and date here):
Your answer
Carpooling Release:
In youth group, youth may carpool with adult drivers to attend VAPC or Presbytery events.
[Parent/Guardian] I hereby release Varsity Acres Presbyterian Church and the drivers from any and all liability in the event of an accident. (sign and date here)
*
Your answer
Photo and Artwork Release
On occasion photographs may be taken during our programs. These photos, with your permission, may be used in the following ways. Please indicate below your permission to use photos for VAPC purposes.
*
Yes
No
Photos may be used as a part of our online worship (Youtube/livestream).
Photos may be used in VAPC Update (newsletter) with first name only.
Photos may be posted on the VAPC website, Twitter and Facebook with the name of the group only (ie. Youth Group Bowling)
Yes
No
Photos may be used as a part of our online worship (Youtube/livestream).
Photos may be used in VAPC Update (newsletter) with first name only.
Photos may be posted on the VAPC website, Twitter and Facebook with the name of the group only (ie. Youth Group Bowling)
On occasion artwork, created during our programs, may be used in the following ways. Please indicate below your permission to use your child's artwork for VAPC purposes.
*
Yes
No
Artwork may be used as a part of our online worship (Youtube/livestream).
Artwork may be used in VAPC Update (newsletter) with first name only.
Artwork may be posted on the VAPC website, Twitter and Facebook with the name of the group only (ie. Youth Group Bowling)
Yes
No
Artwork may be used as a part of our online worship (Youtube/livestream).
Artwork may be used in VAPC Update (newsletter) with first name only.
Artwork may be posted on the VAPC website, Twitter and Facebook with the name of the group only (ie. Youth Group Bowling)
[Parent/Guardian] I hereby grant permission to Varsity Acres Presbyterian Church to use photographs and/or artwork for the purposes mentioned above. (sign and date here)
Your answer
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