ROCK Registration Form Fall 2023

Rock On Christian Kids at APC

* The Fall session of ROCK begins September 28th and will run through December 21st.

* The Spring session of ROCK will begin January 18th and will run through May 9th. The ROCK musical is Friday, May 17th and Sunday, May19th.
* ROCK is held on Thursday evenings from 5:00-7:30 pm.

* Drop off and Pick up is in Schulte Hall at Allentown Presbyterian Church, 20 High St.
* Some portions of the ROCK evening may be held OUTSIDE so please dress the kids according to the weather. Please don't send the kids to ROCK with any fancy clothing. Dress for crafts and possibly working outside!;)

Parents are expected to monitor their child’s health. We respectfully ask that if your child is sick, you please keep them home.
We are excited to begin another year of ministry with kids as we Partner with Parents to raise kids with faith that lasts!

Name of child you are registering. Please submit a form for each child being registered.

Name of Child

Address

Age

Birthdate

Grade

School

Things we should know about your child:

My child is participating as a:

Choir Kid Caring Kid Undecided at this time

Has your child been baptized?

Yes No

Does your child read at grade level?

Yes No

Does your child write at grade level?

Yes No

Is your child shy about reading out loud?

Yes No

How does your child get along with peers?

Does your child read music?

Yes No

Does your child play any instrument?

Yes No

If so, which?

Does your child have any medical conditions, food or other allergies?

Does your child have any special needs about which we should be aware? Please also see ROCK leader for more information about our Inclusive Ministries Committee.

Is there anything special we should know about your child so we can help them grow in their faith?

Parent Info

Parent Name (first and last)

Cell parent #1

Email parent #1

This address will receive a confirmation email

Address parent #1, if different from child's.

Are you a member of APC?

Yes No

Church affiliation.

How did you learn about ROCK?

Are you interested in learning more about APC?

Yes No

Name parent #2 (first and last)

Cell parent #2

Email parent #2

Address, if different.

Parent #2, are they a member of APC? Yes No

Emergency Contact (in the event that the parents cannot be reached) Must not be a ROCK leader:

Name/Relation

Phone

Safety Policy:

I would like a copy of the APC Child and Youth Safety Policy.

Yes No

Release for Publication:

Date

I, the undersigned, hereby 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 published material (includes print, web based, or other media types) that may be presented in the public domain (outside of Church services or Church-sponsored programs, ministries, activities, or events) for the purpose of promoting Church-Sponsored programs, ministries, activities or events.

I give permission as outlined above. I do NOT give permission as outlined above.

Electronic Signature*

Date

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

Health Policy

I agree to monitor my child's health (i.e. stomach flu, fever, diahhrea, Covid, etc.) and to follow CDC guidelines regarding COVID symptoms, exposures, and testing when deciding whether or not to send them to ROCK, Stepping Stones, Sunday School or any other APC ministry program or event.

Electronic signature

Date

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

Volunteer Opportunities:

Please come and join us!! Be a part (no matter how small) of Children's Ministry at APC!

One parent per family is asked to contribute dessert and their time one evening each session as part of the ROCK registration. During that evening (5:00-7:30 pm) you may be helping in the kitchen, assisting with the craft, helping clean up...whatever might be needed.

A Sign-up sheet is available at the registration table.

Besides the above options I'd like to offer the following help:

Fall Session Fee

The half-year session fee is $50 per child, $90 for 2 children, and $125 for 3 children. The fee covers the cost of dinners, crafts and other supplies.

If paying by cash or check:
1. Select "pay by cash or check $0" in the Payment field below.
2. Then please see a ROCK leader at the registration table on Thursday.

Please make checks payable to Allentown Presbyterian Church. Memo: ROCK

If paying by credit card this will require a separate transaction per child registered. Please select the correct graduated charge amount in the Payment field below.

As always, assistance is available for those with financial need. Please speak with a ROCK leader privately.

Payment

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

ROCK Registration Form Fall 2023 - Spring 2024

Description

ROCK Registration Form Fall 2023 - Spring 2024

Description

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