2019 & 2020 Youth Registration and Permission Slip

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Grades 6th through 12th
Please select all that apply.
Student Information:

 
Please select one option.
 
 
*If you would like your child to receive text reminders.
 
 
 
Parent Information:

 
 
 
 
 
 
Please select all that apply.
 
 
 
 
 
 
 
Please select all that apply.
My child (listed above) has permission to participate in all activities on the Allentown Presbyterian Church campus, including off-campus events, such a mission nights, special events and retreats. I understand my child will be traveling, either by foot or vehicle, with a church-approved Shepherd. I grant permission to the Allentown Presbyterian Church to take and publish photographs, video, voice recordings, or any other likeness of my child for use in materials, both print and digital, that may be presented in the public domain for the purpose of promoting APC’s programs and ministries. In the event of a medical emergency, I understand that I will be contacted immediately to authorize care. If I cannot be reached, I authorize Crossroads Youth & Young Adult Ministry staff to approve care.
 
 
*By entering my name in the box above, I am providing my digital signature on this form.
If you have any questions please contact Karen Collins at (609) 273-4860

Description

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