2026/27 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

School

Health Concerns

Student Information #2

Name

Birthday

School

Health Concerns

Student Information #3

Name

Birthday

School

Health Concerns

Additional Kids

Programs

We have a variety of programs to offer to kids of all ages!

Blacktop Rec is for 1st-8th graders during the summer and runs Monday - Thursday from 12pm to 4pm from June 15 to August 6.

Nursery is available all year long during our Sunday morning worship gathering.

Kingdom Kids is available all year long during the second half of our Sunday morning worship gathering. It is for kids who are potty trained through kindergarten.

Discovery Time is our Sunday School Classes for K-5th Grade that runs during most of the school year.

Kids Club is our Wednesday evening programming for Kids K-5th Grade that runs September - March.

Middle School Youth Group happens Wednesday nights and is designed for 6th-8th graders and runs most of the school year.

High School Youth Group happens Sunday nights and is designed for 9th-12th graders and runs most of the school year.

I am interested in the following program(s) for my child(ren).

Blacktop Rec (Monday - Thursday, June 15 - August 6, 12pm-4pm) Nursery (Sunday morning) Kingdom Kids (Pre-K Sunday morning) Discovery TIme (K-5 Sunday morning) Kids Club (K-5 Wednesday evenings) Middle School Youth Group (Wednesday night) High School Youth Group (Sunday night)

New for Blacktop Rec 2026:

In order to better partner with the Boys and Girls Club (BG) and families in the community, we're gauging interest in helping kids get from BG program to our program, Blacktop.

We'd love to help any child who attends 'BG' safely travel to Blacktop Rec at Noon, if they wish. If there is interest in this service, parents would indicate to 'BG' that their child is a 'walker' making it so they are able to leave the Club on their own. We would then have a couple of our staff members ready outside of 'BG' to walk with them across 8th Street to Blacktop Rec.

Would this be of benefit to you and your family? Yes No

Digital Signature

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

2026/27 Family Registration Form

Description

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