Youth Program Registration

Register

Information received is confidential and is being gathered for the purposes of serving your Child while in the care of “Rooted – Humboldt Youth Group” (Rooted – HYG). Any medical information collected here serves to authorize “Rooted – HYG” , and its Staff and Volunteers, to obtain medical assistance in emergencies. This form shall be completed annually by the Parent/Care Giver.

Date of Birth *

In Case of Emergency

Consent

1. Does your child have any physical, emotional, mental, behavioural concerns or limitations that staff should be aware of? *

Yes

2. Is your Child bringing any medication with him/her? *

Yes

3. I/We grant permission for the reasonable use of pictures containing your Child in any or all of the following ways: *

Social Media Networks

Newsletters

Church Prayer Card/Sponsor

Website

4. Communication: I/We grant permission for the Youth Program Personnel (staff, volunteers, and other students) to communicate with your Child via… *

Text Message

Social Media Networks

Please add your phone

Please add your email

5. Parent Communication: I/We grant permission for Youth Program Personnel (staff, volunteers, and other students) to communicate with me for Junior Youth future events via… *

Phone

Please add your phone

Please add your email

6. I/We grant permission for the Youth Program Personnel to share information to the local church for purpose of prayer support/prayer sponsor. *

Yes

By using this form you agree with the storage and handling of your data by this website.

Program Details

Date: Wednesdays
Time: 7:00 pm
Ages: Junior Youth = GR 6 – 8 are at Humboldt Alliance Church while SR Youth = GR 9 – 12 is at Humboldt Bible Church

*Refer to the events calendar for accurate dates and times. Some programs may be cancelled or changed without notice.

For assistance, please email humboldtalliancechurch1@sasktel.net

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