Children and Youth Formation Registration

Thank you for your interest in registering for our children and/or youth programs. We strive to provide a safe and affirming place for people of all ages. Please complete the registration below prior to attending any children and/or youth programs, this is required.

If you have any questions please contact the church office (931) 645-2458 or email us.


Parent Name:*
Address:*
Primary Phone:*
-
E-mail:*
Child 1 Name:
Birthday:
 / 
 / 
Grade:
Allergies/Other Concerns:
Trinity Children and Youth Formation Activities:
Child 2 Name:
Birthday Child 2:
 / 
 / 
Grade child 2:
Allergies/Other Concerns Child 2:
Trinity Children and Youth Formation Activities (child 2):
Child 3 Name:
Birthday Child 3:
 / 
 / 
Grade child 3:
Trinity Children and Youth Formation Activities (child 3):
Additional Emergency Contact

In the event of an emergency, we will make every attempt to contact a parent. Please provide names of two people to contact if a parent cannot be reached. Be sure to list the names of people who usually know your whereabouts. 
Contact 1:*
Relation to Child/Youth:*
Contact 1 Phone:*
-
Contact 2:*
Relation to Child/Youth Contact 2:*
Contact 2 Phone:*
-
Medical Treatment

As a parent and/or guardian of the minor(s) listed on this form, I do herewith authorize the treatment of a qualified and licensed medical physician. This authority is granted only after reasonable effort has been made to reach me. I release Trinity Episcopal Church, their employees, and volunteers from any claim of liability in connection therewith. Dates of this release is September 2020 - August 2021.
I grant medical treatment permission:*
Events/Activities:

I grant permission for the minor(s) listed on this form to attend on-site & off-site events and activities of Trinity Episcopal Church. I will be notified in advance of each activity.
Events/Activities Permission:
Publicity

I grant permission for the minor(s) listed on this form to be photographed and/or video for possible use in Trinity Episcopal Church promotions and/or social media which may include the website, Facebook and Instagram. 
Publicity Release:*
COVID-19

I understand it is required that all attendees and anyone staying on the church campus must do a check-in which includes a temperature check and questionnaire. I also agree that all attendees and anyone opting to stay on site must:
  • Wear a mask/face covering at all times.
  • Maintain a social distance of at least 6 feet.
  • To stay home if not feeling well, have a fever, and/or have been exposed to anyone who has tested positive for COVID-19. 
COVID-19 Release:*
Date:*
 / 
 / 
Electronic Signature:*
Word Verification:
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