3Stone Youth Registration 2019-2020

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Student Information

 
 
Please select one option.
 
 
 
 
 
 
 
 
 
Parent's Information

 
 
 
 
In Case of Emergencies

 
 
 
Additional Information

Please select one option.
 
Please select one option.
 
Permissions and Consents

The following sections are permissions and consents that 3Stone/NYCAC needs in order to best serve the youth. Please read through the statements and answer questions where required. At the end of the section, please type your name into the box to consent to the statements and questions.
Emergency and Medical Consent

The safety of your child is our primary concern. Precautions will be taken for his/her wellbeing and protection.
I/We, the parents or guardians named below, authorize one of the 3Stone/NYCAC Ministry Personnel to sign consent for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for the participant named above.

I/We, named below, undertake and agree to indemnify and hold harmless 3Stone/NYCAC, 3Stone/NYCAC's executors, administrators, heirs or assigns from and against any loss, damage or injury suffered by the participant as a result of being part of the activities of the 3Stone/NYCAC, as well as any medical treatment authorized by the supervising individuals representing the church. This consent and authorization are effective only when participating in or traveling to the events of 3Stone/NYCAC. 

Communication

3Stone/NYCAC has a policy in effect that communication is to be used solely for the dissemination of information.

I/We, named below, grant permission for Youth Ministry personnel (staff and volunteers) to communicate with your Child via telephone, email, social media and text.
Please select all that apply.
Photos and Media

From time to time, 3Stone/NYCAC will use pictures of your children in various ways. 

I/We, named below, grant permission for Youth Ministry personnel (staff and volunteers) for reasonable use of pictures containing my child as checked below:
Please select all that apply.
Permission and Extent

3Stone/NYCAC is collecting and retaining this personal information for the purpose of enrolling your child in our programs, ministries, to assign the student to the appropriate classes, to develop and nurture ongoing relationships with you and your child, and to inform you of program updates and upcoming opportunities at our Church. This information will be maintained indefinitely. If you wish 3Stone/NYCAC to limit the information collected or to view your child's information, please contact Pastor Cris.
Signature Options

1. Long Term Option (for all Youth Ministries): I have read, understand and agree with the above and sign it to cover all 3Stone/NYCAC Youth Ministry activities for 2019/2020 year.
Please select all that apply.
 
OR
2. Single Event Option (for single Youth Ministry event): I have read, understand and agree with the above and elect not to consent to the entire year as presented in option 1. In lieu of that, I hereby give consent for my youth to participate in the 3Stone/NYCAC Youth Ministry activity listed below only.
 
 
Please select all that apply.
 

Description

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