Registration for Girls Ministries and Royal Rangers 2022-2023

PLEASE FILL OUT ONE FORM PER CHILD.

To Register for a 2022 - 2023 Royal Rangers or Girls Ministries club (K-6th Grade), you must complete this enrollment form per each child.

Orientation Night will be held on September 9, 2022 at 7:30PM in the MMC Building (74 South Grove Street). Parents are required to attend.

Classes will begin on September 16, 2022 at 7:30PM. Royal Rangers meet in the Valley Stream Campus main building and Girls ministries meet in the MMC building.

*$50 registration fee per child applies

Registration Details

Child's First Name

Child's Last Name

Age

Birthday

Gender

Male

Female

Grade

Does your child have any allergies or medical informtion we need to know?

Yes

Please list all allergies, especially food allergies (Some clubs may have a snack for the children - caregivers are to provide snack for children with allergies) If none, please type N/A

Special Needs or Limitations (physical or educational) If your child has a special need, please specify how we can best take care of him/her while they are in our care.

Parent/Guardian's Full Name

Parent/Guardian's Phone Number

Parent/Guardian's Email Address

Street Address

City

Region/State/Province

Postal / Zip code

What church do you attend or are a member of?

Please select the applicable program in which you are registering your child for

Royal Rangers

Girls Ministries

Do you commit to attend the orientation on September 9 at 7:30PM?

Yes

Does your child need a uniform? If yes, include size

Emergency Contact Information

PLEASE LIST SOMEONE OTHER THAN YOURSELF. We only need this information in case we cannot get in touch with you first.

Emergency Contact Full Name

Relationship to Child

Phone Number

Secondary Phone Number

Additional Guardians | Please list any other persons who are authorized to pick up and their contact information along with their relationship to the child.

Siblings who are also registered for Royal Rangers or Girls Ministry | Please note that by listing a sibling, this does not mean that they are registered. EACH CHILD NEEDS A SEPARATE REGISTRATION FORM.

Consent

Royal Rangers and Girls Ministries are part of Bethlehem Kids. By registering your child for Royal Rangers or Girls Ministries at Bethlehem Assembly of God, you are acknowledging and accepting the below terms. I acknowledge and accept that participation in Bethlehem Assembly of God's Royal Rangers and Girls Ministries Programs involve some risk to the participant and may result in various types of injuries. In the case of emergency, whereby my child requires immediate medical attention and I or any other authorized adult cannot be reached, I give permission to the church coordinators, employees, volunteers, or any other representatives to perform and/or seek emergency treatment or procedures by a doctor, hospital or emergency medical team as deemed required for the well-being of my child. I accept personal financial responsibility for any injury or other loss sustained during Royal Rangers or Girls Ministries and/or Commanders/Teachers and/or Administrator and any medical treatment rendered to my child that is authorized by the Children's Ministry Director. By allowing my child to participate in this event, I understand that the church will take reasonable steps to provide a safe environment for my child and to ensure that all equipment supplied by them for the activity is of reasonable standard. I acknowledge that the church will not be liable for any injury that may be suffered by my child, which arises either directly or indirectly from, or in connection with, the activity described in the schedule incorporated in this form. I hereby agree to indemnify the church against any and all claims arising from, or in connection with, any injury that may be suffered by my child, or that my child may cause to another person, as well as any loss or damage to property, equipment or personal effects belonging to my child, or any other person, arising either directly or indirectly out of or in connection with the activity described in the schedule incorporated in this form. I release my child’s picture to be used in video and photography promoting future Children’s Ministry events of Bethlehem Assembly of God, as well as to be uploaded to Bethlehem Assembly of God’s social networking sites during/after the program.

I have read and understand the Terms and Conditions for registering my child for Royal Rangers/Girls Ministries 2022 - 2023 and agree to the stated terms without reservation.

Your Signature

Thanks for registering!