Student Online Registration Form
Please complete this form to register for one of our ministries. Should you have any questions, please contact us. Please identify who you want to recieve information about our Student Ministry.
Program:
Release and Indemnity
In the event that your child requires special medication, x-rays or treatment, the contact persons you indicate above will be notified immediately. In case of surgical emergency, I hereby give permission to the physician selected by Richmond Hill Baptist Church (the “Church”) to hospitalise, secure proper treatment for, and to order injection, aesthesia or surgery for my child/dependents as named on this form. Your child must be covered by Provincial Health Insurance or equivalent medical insurance and your signature below indicates such insurance is up to date.
I authorize my child to participate in the selected Church program and I hereby agree, by my signature below, to irrevocably release Richmond Hill Baptist Church, its staff, and its volunteers from any and all actions, causes of action or claims (including claims for negligence) for any damages, expenses, losses or injuries arising from or relating to my child's participation in such activity or from the transportation of my child to and from the activity (Parents will be notified in advance for any off-site activity).
I also understand that the Church may take photographs and recordings during the Church's activities for the purpose of promoting the Church. I give permission to the Church to photograph or record my child for such purpose and I waive all rights, including copyright, in such materials and transfer such rights to the Church.
If Other, please describe:
Adult Participant or Parent / Guardian Information:
City:
Postal Code:
Email Address:
Home Phone:
Cell Phone:
Work Phone:
Other:
Mailing Address:
Name(s):
Student Information:
First Name:
Student #1
Student #2
Student #3
Age:
Last Name:
Grade:
years
years
years
Allergies:
Other Needs or Special Instructions:
If you need to register more than 3 students, please submit a separate electronic form.
AB Healthcare #:
Email Address:
Home Phone:
Cell Phone:
