New Student Registration

Student Name

First Name

Last Name

Birthday

MM

DD

YYYY

Email

Phone Number

(###)

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Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Waiver

I, the undersigned parent or legal guardian of the kid(s) names below, do hereby grant my permission and consent for the said kid(s) to attend and participate in the events and activities of EFA Church Youth Ministry, both on and off church grounds, including the necessary transportation to and from these events and activities.

I further agree not to hold EFA Church/EFA Church Youth Ministry or any of it’s paid staff or volunteers responsible for any accident that may occur on the way to, from, or during an event. I indemnify, defend, and hold harmless EFA Church for all claims made and liabilities assessed against them as a result of any activity or event. I release EFA Church and all medical providers from liability in acting on my behalf in this regard and rendering such medical treatment. I assume the risk and financial responsibility for any injury resulting from an event or activity.

By signing below, I am acknowledging that I have read through and understand the above statements.

Student Name

First Name

Last Name

Student Name

First Name

Last Name

Student Name

First Name

Last Name

Guardian's Phone Number

(###)

###

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Allergies/Need To Knows

Guardian Name/Signature

First Name

Last Name

Insurance Provider

Policy Number