Youth Registration 2024/2025

Student Information

Parent/Guardian 1

Parent/Guardian 2

Emergency Contact

Health Information

Permissions

Photos/vidoes

Communication

Transportation

Knowing that all precautions have been taken for the safety and health of my youth, some activities including transportation carry with them the inherent risk of personal injury; I/we give permission for my youth to be transported in a motor vehicle driven by the youth leaders to any/all youth events of September 1 2024 to August 31, 2025 I/we understand that my youth is required to follow all applicable laws regarding riding in a motor vehicle and is to follow all rules set out by the drivers of the vehicles. I/we will not hold RPAC, staff, or volunteers responsible and do indemnify them of any loss, damage or injury suffered by the participant.

Medical Consent

I/we, the parents or guardians named below, authorize the staff or one of Rosewood Park Alliance Church Program 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 named on this form. I/we, undertake and agree to indemnify and hold harmless Program Personnel, Rosewood Park Alliance Church, and it’s leaders from and against any loss, damage or injury suffered by the participant as a result of being part of the activities of Rosewood Park Alliance Church, as well as of any medical treatment authorized by the supervising adults representing Rosewood Park Alliance Church. The consent and authorization is effective only when participating in or traveling to events sponsored by Rosewood Park Alliance Church.

Purpose and Extent

Rosewood Park Alliance Church is collecting and retaining this personal information for the purpose of enrolling your child in our programs, to develop and nurture ongoing relationships with you and your child, and to inform you of program updates and upcoming opportunities. This information will be maintained indefinitely as it is a requirement of our insurance company and legal counsel.

Parent/Guardian options

I have read, understood and agree with the above and sign it to cover all Youth program activities from the date signed to August 31 2025. I understand I will be asked for separate permission for overnight events.