J.O.Y. Club Registration
Please fill out this form for each child you are registering for J.O.Y. Club. To assist in planning, PLEASE register your child(ren) by Friday, October 23! For additional questions regarding J.O.Y. Club, please see our church website www.LeRoyCov.org.
Child's Last Name *
Child's First Name *
What grade is your child in? *
For grades K - 5, who is your child's teacher?
What is your address? *
What is your city? *
What is your zip code? *
Parent/Guardian 1 Name (First and Last) *
Parent/Guardian 1 Phone Number *
Parent/Guardian 2 Name (First and Last)
Parent/Guardian 2 Phone Number
Email Address *
In case my parents cannot be reached, please contact this person: (First and Last name)
In case my parents cannot be reached, this is the phone number of my emergency contact person:
My child will be arriving each Wednesday via: *
We want your child's experience at J.O.Y. Club to be the very best possible, so please let us know if there is anything we need to know about your child that will help us serve them better (allergies, behavioral concerns, etc.):
Pick Up Procedures: Children will be grouped together by how they are picked up. Each child/group of children (whether it be siblings, friends, etc.) will be given a color and will sit at a designated area of the Sanctuary or Fellowship Hall for adults to locate them and sign the child or “group” out. PLEASE adults, make sure to sign out your child/group each Wednesday so that we can ensure the safety of all the children. This year students will be signed out in various areas to reduce people gathering in large groups. Volunteers will help parents locate pick up areas. Please list below adults, in addition to the parents and emergency contacts listed above, that may pick-up your child from J.O.Y. Club (if any):
Participation Waiver : I certify that my child has permission and consent to participate in the above Program. I further stipulate and agree to protect, indemnify, save, and hold harmless said Evangelical Covenant Church of Leroy employees and volunteers against any and all claims arising out of my child's participation in this Program. I also certify that my child has no medical conditions or injuries that preclude his/her participation in this program. I give my permission for photos/videos to be taken and used for public relations purposes. By submitting this form for J.O.Y. Club Registration, I agree to the Waiver of Participation.
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