Child's Full Name *

First Name

Last Name

Parent 1 Full Name *

First Name

Last Name

Parent 2 Full Name

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Primary Phone Number *

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Secondary Phone Number

(###)

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Date of Birth *

MM

DD

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Full Name *

First Name

Last Name

Primary Phone Number *

(###)

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Secondary Phone Number

(###)

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Does the child you are registering have any allergies, dietary concerns, medical conditions or disabilities that we need to be aware of? *

Yes

No

Family Doctor's Name *

First Name

Last Name

Medical Release *

The safety of your child is our primary concern. Precautions will be taken for their well-being and protection. I agree to any emergency treatment to be given as considered necessary. I undertake and agree to indemnify and hold harmless Calvary Gravenhurst and its leaders from and against any loss, damage or injury suffered by the participant as a result of being part of the activities of Calvary Gravenhurst, as well as of any medical treatment authorized by the supervising individuals representing Calvary Gravenhurst. This consent and authorization is effective only when participating in to events sponsored by Calvary Gravenhurst.

Yes

No

Ministry Care Release *

Calvary Gravenhurst believes in excellence in our entire Children’s Ministry Department. It is always our endeavour to care for your child(ren) to the best of our ability while they are entrusted to us. At any time, we reserve the right to not admit your child into the classroom should there be signs of any communicable disease or sickness i.e. colds etc. Your child(ren) will only be released to the parent/guardian and/or those whom you have authorized above.

Yes

No

Media Release *

I agree to photographs and short videos of activities including my child to be taken for use within the church community and for possible publication.

Yes

No

Please read and confirm that you commit to following the actions in order to prevent the spread of COVID-19 at Calvary *

I will do the health assessment for my child(ren) provide by Calvary Gravenhurst each time I am registering for a Sunday service. I will keep my child(ren) home from church if my child(ren) has any TWO of the symptoms listed on the Calvary Gravenhurst health assessment. I understand that if my child(ren) shows signs of any TWO symptoms, that they will be removed from the classroom and I will be asked to collect them from the children’s ministry area. I will send my child to Calvary’s children’s ministry programs with a face covering to be worn throughout the duration of the Sunday service. (Only required for elementary aged programming) I understand that Calvary Gravenhurst has an expectation for appropriate behaviour throughout their children’s ministry programs. In addition to these expectations students are expected to follow the required safety expectations as part of the reopening of children’s ministry during the COVID-19 pandemic. All members of the church community, including teacher, volunteers, students, and parents/ guardians must: • Adhere to required hygiene procedures (face-coverings/masks, hand-washing. cough/ sneeze etiquette, not sharing food, washroom use, no biting etc). • Adhere to required distancing procedures (distancing, placement of personal items).

Yes

No

Digital Signature *

I have read, understood and agree with above and sign it to cover all Children’s Ministry Program activities for the program year effective as stated below I give consent to my child taking part in the programs selected above, group social events and group Sunday morning events during the service. I understand that if any information on this form changes, it is my responsibility as a parent/guardian to make the organizers aware in writing so that changes can be made to Calvary Gravenhurst's database.

First Name

Last Name

Date *

MM

DD

YYYY