Youth Registration with Parental Permissions (to be updated annually)

First Name *

Tip: Youth or Child's First Name

Last Name *

Tip: Youth or Child's Last Name

Mobile Number

Tip: Youth or Child's Mobile #

Email Address

Tip: Youth or Child's Email Address

Date of Birth *

Tip: Youth or Child's Date of Birth

School Grade *

Tip: Youth or Child's School Grade

Allergy Information

Allergy Action Form?

Parent Names *

Parent Emails *

Authorized Pick-Names (if parent's aren't transporting) *

Photo Disclaimer:

Photo Disclaimer: I understand my teen may be photographed in public group activities and church group activities. As a result, my child's group photo may be included on screens in worship, online (Facebook, Instagram, Topeka FUMC Website, Et al) in newspapers, *

Electronic Communication with Youth:

Topeka FUMC communicates with visitors & members via email and text. We also communicate with youth via "GroupMe." Parent's must giveTopeka FUMC permission to contact children or youth via these platforms.

Youth Specific Permissions (6th-12th grade) *

Yes, permission to contact my youth via "Text-In-Church" platform

Yes, permission to contact my youth via church email (never via a leader's personal email)

Yes, permission to contact my youth via "GroupMe."

No, only use the parent email/cell to contact my youth.

I don't have a youth in 6-12th grade.

PARENT COVENANT
I, the parent or guardian, being the undersigned and intending to be legally bound, agree my child/teen may participate in all programming sponsored by Topeka FUMC. I am aware of the following:

Contact Info: I will keep my contact information up to date on this sheet or online so I may be contacted as needed.

Waiver of Liability: I waive and release all rights and claims for damages, injury, accident, or liability of any kind which I might have against Topeka FUMC, clergy, staff, volunteer leaders, and other participants. My child/teen will participate at his/her own risk.

Dismissal Procedure
 For teens: I understand that staff and volunteer leaders of Topeka FUMC are responsible for my teen only while they voluntarily remain with the group. Teens may dismiss themselves. However, if my teen were to leave the group, I understand Topeka FUMC, clergy, staff, or volunteer leaders may attempt to contact me but are not responsible. I have discussed this with my teen, and my teen is aware of our expectations. I understand my teen may be sent home early if they do not follow the rules.

By typing your name, you agree to the above Parent Covenant. *