Glad Tidings Pentecostal Church
REGISTRATION & CONSENT FORM
For the school year 2023/24

Information received is confidential and is being gathered for the purposes of serving your Child while in the care of Glad Tidings Pentecostal Church, PAONL. Any medical information collected here serves to authorize Glad Tidings Church, and its staff and volunteers, to obtain medical assistance in emergencies.

In the case of custody agreements, please include the proper form authorizing Parental contacts.

Student's Name *

Date of Birth *

Grade *

Students Cell Phone*If provided, will only be used for The Gathering Student Ministries’ information and promotion.

Parent/Guardian Name *

Street Address *

City *

State/Province *

ZIP / Postal Code *

Parent/Guardian's Phone Number *

Parent/Guardian's Email *

Health Card Number *

Family Doctor *

Doctor's Phone Number *

Allergies

In case of emergency, contact *

Does your child have any physical, emotional, mental, behavioural concerns or limitations that staff should be aware of?YesNo

If Yes, please explain:

Is your Child bringing any medication with him/her?YesNo

If Yes, please explain:

The safety of your Child is our primary concern. Precautions will be taken for their well-being and protection.

I/we, the Parents or guardians named below, authorize the leader or one of the staff at Glad Tidings Pentecostal Church (PAONL) to sign a consent for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for the participant names above.

I/we, named below, undertake and agree to indemnify and hold harmless Program Personnel, Glad Tidings Pentecostal Church (PAONL), and its Leaders from and against any loss, damage or injury suffered by the participant as a result of being part of the activities of this church, as well as of any medical treatment authorized by the supervising individuals representing this Church/Pentecostal Assemblies of Newfoundland and Labrador.

This consent and authorization is effective only when participating in or traveling to events sponsored by Glad Tidings Pentecostal Church (PAONL).

Photos

Please sign below to grant permission for the reasonable use of pictures containing your Child in any or all of the following ways:

Purposes and Extent

Glad Tidings Pentecostal Church (PAONL) is collecting and retaining this personal information for the purpose of enrolling your Child in our programs, to assign the student to appropriate classes, to develop and nurture ongoing relationship with your and your Child, and to inform you of program updates and upcoming opportunities at Glad Tidings Pentecostal Church.

This information will be maintained indefinitely as it is a requirement of our insurance company and legal counsel. If you wish Glad Tidings Pentecostal Church (PAONL) to limit the information called, or to view your Child’s information, please contact us.

I have read, understood and agree with the above.

Signature *

Printed Name *

Date *

At Glad Tidings Pentecostal Church your child is a priority. Our goal is to ensure they are taught, shaped, safe, belong, and most importantly shown the love of God.

Glad Tidings Pentecostal ChurchREGISTRATION & CONSENT FORMFor the school year 2023/24

Photo Permissions

Glad Tidings Pentecostal Church
REGISTRATION & CONSENT FORM
For the school year 2023/24