2025-26 BLAST Registration
Believing, Loving, And Serving Together
At Antioch Covenant Brethren Church
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Child's Name *
Grade level for 2025-26 school year: *
School Attending *
Parent/Guardian Name *
Will your child be riding the Blast bus/van?
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Parent/Guardian Email *
Parent/Guardian Phone Number *
Child's Address *
Does your child have any allergies? *
Does your child have any medical conditions we should know about? *
I authorize all medical and surgical treatment, X-ray, laboratory, anesthesia, and other medical and/or hospital procedures as may be performed or prescribed by the attending physician and/or paramedics for my child and waive my right to Informed Consent of Treatment. This waiver applies only in the event that neither parent/guardian can be reached in the case of an emergency.   *
My child may be photographed and/or videotaped by Antioch Church during activities and/or events. This photo release gives Antioch Church permission to photograph your child and release said photos for publication online and/or print media. I understand that photographs and videotapes may be released to the media and the public to promote Antioch Church programs and/or events. You may modify the permissions in this release at any time in writing.   *
List any court appointed restrictions.
By signing my name I am giving my child permission to attend  Antioch Church Wednesday Night BLAST.  *

CODE OF CONDUCT

1.       BLAST is your time to learn about Jesus.  To do this we must respect each other, the adult leaders, and our kitchen volunteers.  It’s easy to show respect to those around you- say please and thank you, clean up your tables after dinner, and when you are asked to do something by an adult- Do it!

 2.      This building is where we worship God.  While you are here, we must respect the church.  Horseplay, running, fighting, or vandalism will not be tolerated at BLAST.  (Vandalism could include writing in hymnals or Bibles, on welcome cards or offering envelopes or defacing the classrooms or bathrooms.)

 3.      We will use language that is pleasing to God.  Foul language, curse words, name calling or bullying is not pleasing to God and will not be tolerated at BLAST.

 4.      The “L” in BLAST stands for LOVING.  We will love our neighbors and ourselves, therefore fighting and bullying of any sort will not be tolerated.

 5.      The Third Commandment says, “You will not take the Lord’s name in vain.”  God’s name is Holy!  Only use God’s name when praising Him!

 6.      While you are at BLAST, all cell phones are expected to remain in your book bag or pocket and may only be used during recreation in the designated area. Your focus should be on building your relationship with God and others around you.

 7.      Bible time with Pastor Bowers is time spent in God’s sanctuary.  When you attend BLAST, we want you to learn about Jesus and this is YOUR time!  Absolutely no cell phones, toys, food, drinks, or other distractions allowed during Bible time.  Also, please respect the sanctuary by not putting your feet on the chairs or other furniture.

 8.     Bathroom use:  Everyone must get a bathroom pass if they want to use the restroom during the outdoor play time.  During outdoor time, only the downstairs bathrooms may be used.  Bathroom breaks will not be allowed during Bible time except in the case of an emergency. 

 9.      Keep your hands to yourself and no public displays of affection during BLAST.

 

Bus Rules:

1.       No yelling, screaming or throwing things.

2.      Stay in your seat until the bus stops.

3.      Always listen to the bus driver.

4.      Follow the same rules as your school bus.

 

Consequences for breaking the rules:

First offense:  A verbal warning from the leader or volunteer.

Second offense:  A verbal warning and your parents will be notified.

Third offense:  Parents will be asked to keep you home from BLAST for one week.

Fourth offense:  You will be asked to leave the program for the rest of the semester.  (We don’t want that to happen!)


I have read the Code of Conduct (or my parents have read it to me) and I agree to abide by the rules while I am at Antioch Church for BLAST.  I understand the consequences of not following the rules and I agree to abide by them.

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