Youth Ministry Registration and Consent Form 2025-2026

The information received is confidential and is being gathered for the purposes of serving your Child while in the care of Harvest Bible Church (HBC). Any medical information collected here serves to authorize HBC and its Staff and Volunteers to obtain medical assistance in emergencies. This form should be completed annually by the Parent/Guardian.

Once this form is completed, we will add you (and any students requested) to our updates group in the church center app.

Your name *

Email address *

Family Information

Address *

Phone number *

Family Doctor *

Full name - Phone #

Emergency Contact *

Full name - Relationship - Phone #

Student Information

Household members

Please only add information for students who are participating in Harvest Youth. Under "medical notes" you can list any known allergies.

What grade is your student(s) in? *

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

Is your child bringing any medication with him/her? *

Please explain *

Please include the name of each applicable child in your description

Consent

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 Blake Hill or one of HBC Youth Ministry Personnel, in the case of a medical emergency, to sign a consent for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for the participant(s) named above.

I/we, named below, undertake and agree to indemnify and hold harmless Ministry Personnel, HBC, 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 HBC, as well as of any emergency medical treatment authorized by the supervising individuals representing HBC. This consent and authorization is effective only when participating in or traveling to events sponsored by HBC.

Communication *

A policy is in effect that communication is to be used solely for the dissemination of information. Please sign below to grant permission for Youth Ministry Personnel (staff and volunteers) to communicate with your Child via telephone, email, social media and text:

Telephone

Social Media Networks

Text Message

Photos

I grant permission for the reasonable use of pictures containing my Child on HBC’s website, social media platforms or publications.

Parent/Guardian Options

I have read, understood and agree with above and sign it to cover all Youth Ministry activities for the program year effective as stated below. A separate Informed Letter of Consent will be sent home for off-site activities and activities of elevated risk.

Signature *

Please type your name as a signature of your agreement with the above.

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