2025/26 Family Registration Form

Parental/Guardian Permissions

I release Calvary Reformed Church and its staff from all liability for accidents incurred, while being transported as part of the program, as long as no church representative has been grossly negligent.

I give my permission for my child(ren) to be transported to and from Calvary for programs and events. I do not give my permission for my child(ren) to be transported to and from Calvary for programs and events.

Photography

I give permission for my child(ren)’s name, work, photograph, to be used in any Calvary publications, including those online. I do not give permission for my child(ren)’s name, work, photograph, to be used in any Calvary publications, including those online.

To Treat in case of emergency: If you cannot be reached in an emergency, we need to be given permission to treat your child onsite or with a physician selected by Staff to hospitalize, secure proper treatment for, and to order injections, anesthesia, or surgery for your child(ren). In case of an emergency, I understand that every effort will be made to contact me. If I cannot be reached, I hereby give Calvary Reformed Church’s staff permission to act on my behalf in seeking emergency treatment for my child. I also authorize any hospital which has given treatment to my child to release the child to Calvary Reformed Church and its adult staff members when treatment is completed. I also release Calvary Reformed Church and its staff from all liability as long as no church representative has been grossly negligent. (If permission is not given, your child(ren) may not ever be on church premises without you.)

I give Calvary permission to treat my child in this situation or to select proper medical care for my child if I cannot be reached. I do not give Calvary permission to treat my child in this situation or to select proper medical care for my child if I cannot be reached.

Parent/Guardian #1

Your Name

You are

Parent - Mother/Madre Parent - Father/Padre Guardian - guardián(a) Other

This address will receive a confirmation email

Phone

Address

Parent/Guardian #2

Name

You are a Parent - Mother/Madre Parent - Father/Padre Guardian/Guardian(a) Other

Phone

Address if different

Student Information #1

Name

Birthday

Grade Fall 2025

School

Health Concerns

Student Information #2

Name

Birthday

Grade Fall 2025

School

Health Concerns

Student Information #3

Name

Birthday

Grade Fall 2025

School

Health Concerns

Additional Kids

Programs

I am interested in the following program(s) for my child(ren). Blacktop Rec (Monday - Thursday, June 16 - August 7, 12pm-4pm) Nursery (Sunday morning) Kingdom Kids (Pre-K Sunday morning) Discovery TIme (K-5 Sunday morning) Kids Club (K-5 Wednesday night) Middle School Youth Group (Wednesday night) High School Youth Group (Sunday night)

Digital Signature

I have read, understood, and completed the Calvary Family Registration Form. (Please type your name below).

2025/26 Family Registration Form

Description

Please Fix the Following