Online Registration Form for Summer Blast

Online registration for campers (Grades JK-5) has now closed as we have the max number of students signed up for Summer Blast. If you would like to be added on a wait list if we receive any cancellations, please contact Hannah Villeneuve, our summer intern, at hannah@arlingtonwoods.ca.

The below registration form can be used for any teen volunteers for our August 6th event.

All information entered is confidential and is only used by children's ministry personnel. If you have any questions, please contact Pastor Ben Spears at ben@arlingtonwoods.ca

GENERAL RELEASE AND HOLD HARMLESS AGREEMENT

Arlington Woods Church Free Methodist Church

Summer Blast Registration for children JK-Grade 5

The safety of your Child(ren) is our primary concern.  Precautions will be taken for their well-being and protection.

I am the parent or legal guardian (as indicated below) of all minors (children) who have been indicated below, who desire to participate in various programs, events or activities (hereinafter collectively referred to as the “Activities”) operated or sponsored by Arlington Woods Free Methodist Church (the “Church”).

I understand and acknowledge that the Church will not allow participation in the Activities without releasing and holding the church harmless from any liability arising out of participation in the Activities. I have investigated the risks involved in all minors' participation in the Activities and fully understand and assume such risks on their behalf. I acknowledge and agree that I have given consent for all minors indicated here to participate in the Activities and to remain in the custody of the Church’s representatives while participating in the Activities.

I undertake and agree to indemnify and hold harmless Arlington Woods Free Methodist Church, its Program Personnel, and Leadership, from and against any loss, damage or injury suffered by the participant as a result of being part of the activities of Arlington Woods Free Methodist Church, as well as of any medical treatment authorized by the supervising individuals representing Arlington Woods Free Methodist Church. This consent and authorization is effective only when participating in or traveling to events sponsored by Arlington Woods Free Methodist Church.

I authorize the program leader or one of Arlington Woods Free Methodist Church’s Personnel to sign a consent for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for the participant(s) named on this registration form.

Purposes and Extent:

Arlington Woods Free Methodist Church is collecting and retaining this personal information for the purpose of enrolling your children in our programs, to assign the students to the appropriate classes, to develop and nurture ongoing relationships with you and your children, and to inform you of program updates and upcoming opportunities at our organization.  This information will be maintained indefinitely as it is a requirement of our insurance company and legal counsel.  If you wish Arlington Woods Free Methodist Church to limit the information collected, or to view your children’s information, please contact us.

Completing and signing the form below indicates that you have read, understood and agree with the above.

After reading the above, please complete the registration form below.

Parent 1: Name (First and Last)*

Parent 1: Email*

Parent 1: Cell Phone

Parent 2: Name (First and Last)

Parent 2: Email

Parent 2: Cell Phone

Home Address (Please include postal code)*

Home Phone*

Name of Relative or Family Friend who brings child(ren).

Contact Information for Relative or Family Friend (Phone, Email)

Child 1: Name (First, Last)*

Child 1: Birthday (Month, Day, Year)*

Child 1: Grade as of September 2018*

_JKSK123456+ (Youth Volunteer)

I would like to register this child for...

Youth Volunteer (Gr 6+) for Wed August 8

Child 2: Name (First, Last)

Child 2: Birthday (Month, Day, Year)

Child 2: Grade as of September 2018

_JKSK123456+ (Youth Volunteer)

I would like to register this child for...

Youth Volunteer (Gr 6+) for Wed August 8

Child 3: Name (First, Last)

Child 3: Birthday (Month, Day, Year)

Child 3: Grade as of September 2018

_JKSK123456+ (Youth Volunteer)

I would like to register this child for....

Youth Volunteer (Gr 6+) for Wed August 8

Child 4: Name (First, Last)

Child 4: Birthday (Month, Day, Year)

Child 4: Grade as of September 2018

-JKSK123456+ (Youth Volunteer)

I would like to register this child for...

Youth Volunteer (Gr 6+) for Wed August 8

Child 5: Name (First, Last)

Child 5: Birthday (Month, Day, Year)

Child 5: Grade as of September 2018

-JKSK123456+ (Youth Volunteer)

I would like to register this child for...

Youth Volunteer (Gr 6+) for Wed August 8

Additional Info about Child(ren)- (Allergies, medications, behaviour, secondary address, etc.)

Do you attend another church? If so, please indicate.

Your Name. (Typing your name will act as your personal signature and indicate that you have read, understood and agree with the above.)*

Today's Date*

Enter the code displayed*