TrinityYouth Registration TrinityYouth Registration Information Step 1 of 3 33% EmailThis field is for validation purposes and should be left unchanged.Student InformationStudent Name* First Last Birthdate* MM slash DD slash YYYY School*Grade in School* 6th 7th 8th 9th 10th 11th 12th Student Email (if applicable) Please list any allergies: Parent InformationFather's Name* First Last Phone*Email* Mother's Name* First Last Phone*Email* Address* Street Address City State / Province / Region ZIP / Postal Code Preferred Method of Contact* Text Email Emergency Contact*Who do we call in the event we cannot get ahold of either parent?Emergency Contact Phone* Blanket Permission:* I agree.I hereby grant permission for my child named above to participate fully in any or all of the activities/programs that are held on or off-site with the student ministries of Trinity Community Church, Roslyn, PA.Release of Liability:* I agree.I understand that the Staff and volunteers of Trinity Community Church will endeavor to provide individual care and safety for each participant in each activity/program. I am aware that neither the Church nor any staff or volunteer supervisor can assume responsibility for any injury or damage, which may occur in connection with such program/activity. Therefore, by indicating above, I am releasing and/or holding harmless the Church, staff, and volunteers from any liability incurred arising out of any church-sponsord activity in which my child participates.Medical Authorization* I agree.I give my consent, approval and authorization for Church staff or other adult supervisors to authorize emergency medical treatment for my child if reasonably deemed necessary by them.
