Next Gen Program Registration & Release 2026-27

Please complete one registration form per child participating in kids and/or youth ministry programs at Alger Park Church this year. If you have further questions or concerns, please reach out to Fiona (fionab@algerparkchurch.org).

Child Information

Child Name

Birthdate (dd/mm/yyyy)

Age

Gender

Female Male

Grade

Which program(s) does your child plan to attend this school year?

Nursery (Sunday mornings; ages 0-3) Kingdom Kids (Sunday mornings; ages 3yrs-1st grade) Sunday School (after church) Middle School Youth Group (Sunday nights) High School Youth Group (Sunday nights) Quest (Wednesday nights; K-5th grade) Little Neighbors (Wednesdays, 11-12:30)

T-shirt size (indicate youth or adult size)

Contact Information

Parent/Guardian 1

Address

Phone

This address will receive a confirmation email

Parent/Guardian 2

Phone

Church Involvement

Currently attending Alger Park Church Currently attending another church Not attending church Other

Secondary Emergency Contact

Secondary Phone

Secondary Email

Who is authorized to pick up your child from events?

Medical Information

Preferred Hospital

Health Insurance Company Name

Policy Number

If necessary, describe in detail the nature and severity of any physical and/or psychological ailment, illness, propensity, weakness, limitation, handicap, disability, or condition to which your child is subject and of which Alger Park staff should be aware of, and what, if any action of protection is required on account thereof. Include names of medications and other necessary information such as dosages, times, etc.

Does your child have allergies to:

Pollens Medications Food Insect bites No known allergies Other

Describe allergy specifics

If your child has additional dietary needs, please list them here:

Does your child live with, or has ever experienced, or is being treated currently, for any of the following:

Asthma Epilepsy/Seizure Disorder Heart Trouble Diabetes Frequently Upset Stomach Physical Disability None

Other: please explain

Does your child have an updated tetanus shot?

Yes No

Does your child wear Glasses Contact Lenses

Should your child's activity be restricted for any reason? Please Explain

Photo Release

Do you give permission for Alger Park Church to use, reproduce, and/or distribute photographs, films, video, and sound recordings of your child without compensation or approval rights, for use in both printed and website materials created for purposes of promoting Alger Park Church?

I DO give photo permission I DO NOT give photo permission

Transportation Permission

Do you grant permission for the minor listed above to be transported by Alger Park staff and/or volunteer leaders to and from church sponsored activities at Alger Park Church?

I DO grant permission I DO NOT grant permission

Do you grant permission for the minor listed above to attend activities (i.e. field trips, work projects, conventions, special outings) sponsored by Alger Park Church that do not take place on the church property?

I DO grant permission I DO NOT grant permission

Do you grant permission for the minor listed above to be transported by members of Alger Park Christian Reformed Church who are the age of sixteen (16) or over and have a valid driver’s license?

I DO grant permission I DO NOT grant permission

Consent & Release Agreement

Name of Child

has my permission to attend any/all ministry activities sponsored by Alger Park Christian Reformed Church.

This consent form gives permission to seek whatever medical attention is deemed necessary and releases Alger Park Church and its staff of any liability against personal losses of named child.

We/I the undersigned have legal custody of the student named above, a minor, and have given our consent for him/her to attend the events being organized by the Church. I/We understand that there are inherent risks involved in any ministry or athletic event, and I/we hereby release the church, its pastors, employees, and volunteer workers from any and all liability for any injury, loss, or damage to person or property that may occur during the course of my/our child's involvement. In the event that he/she is injured and requires the attention of a doctor, I/we consent to any reasonable medical treatment as deemed necessary by a licensed physician. In the event that treatment is required from a physician and/or hospital personnel designated by the Church, I/we agree to hold such person free and harmless of any claims, demands, or suits for damages arising from the giving of such consent. I/We also acknowledge that we will be ultimately responsible for the cost of any medical care should the cost of that medical care not be reimbursed by the health insurance provider. Further, I/we affirm that the health insurance information provided above is accurate at this date and will, to the best of my/our knowledge, still be in force for the student named above. I/we also agree to bring my/our child home at my/our own expense should they become ill or if deemed necessary by the student ministries staff member.

By checking this box, I/we indicate that I/we agree with all that is stated above

Electronic Parent Signature

* By entering my name in the above box, I am providing my electronic signature for this form.

Next Gen Program Registration & Release 2026-27

Description

Please Fix the Following