Children, Youth, and Families Registration! 2023- 2024

General Info

Your Name and Preferred Pronouns (e.g., "she/her;" "they/them," etc.)

I am a...

Parent Guardian Family Member or Caretaker of Children/Youth Youth (i.e., I am in 6th - 12th grade) Other

Home Address of your Children/Youth

Your Home Address (if different than above)

Your Best Email Address for Reaching You and/or Sending Announcements

This address will receive a confirmation email

Your Best Phone Number for Calls (Cell Phone Preferred)

I receive text messages on this phone.

Yes No Yes but on a different number

Texting Number (if different than above)

Name of Child/Youth in my Household #1 - (please include their preferred pronouns)

Age of Child/Youth #1

Any dietary restriction/preferences or allergies for child #1? (Reply No if none)

Name of Child/Youth in my Household #2 (please include their preferred pronouns)

Age of Child/Youth #2

Any dietary restriction/preferences or allergies for child #2? (Reply No if none)

Name of Child/Youth in my Household #3 (please include their preferred pronouns)

Age of Child/Youth #3

Any dietary restriction/preferences or allergies for child #3? (Reply No if none)

Name of Child/Youth in my Household #4 (please include their preferred pronouns)

Age of Child/Youth #4

Any dietary restriction/preferences or allergies for child #4? (Reply No if none)

Additional Contacts

Name and Pronouns of another Parent, Guardian, or Caregiver of Children/Youth, if applicable

Phone Number of Parent/Guardian/Caregiver #2

Email of Parent/Guardian/Caregiver #2 (if applicable)

Name and Pronouns of an Emergency Contact, who CYF Ministries has permission to contact in the event of an emergency and the parents/caregiver(s) above cannot be reached:

Phone Number of Emergency Contact

Emergency Contact's Relationship to Child(ren)/Youth:

My youth(s) have their own cell phone numbers, and I give CYF Ministries permission to contact my youth(s) directly. (Note: Any direct texts or messages to youth or children must also include a parent/caregiver, and/or another adult or youth in the church. One-on-One communication between youth(s) in the church, and any acting representatives of CYF Ministries, must receive permission from a parent or caregiver on a case-by-case basis.) Yes, I give permission for my youth(s) to be contacted directly (but only privately if I give specific permission).

If "Yes" above, What is your youth's cell number?

Documents and Policies

Documents For all Families to Read:

- St. Matthew's Safe Sanctuary Policies

- Children and Youth Permission Form (To be used when we travel off church property for events.)

Let us know you read them by electronically signing your name at the bottom of this form.

Do any of your children and/or youth have allergies, or food/environmental sensitivities? If so please explain with specific instructions:

Do any of your children and/or youth have medical needs that we need to know about (e.g. regular medications, food requirements, etc.)

Do any of your children and/or youth have other support and/or access needs we need to be aware of (examples: communication, social, physical, etc.):

Do you give permission for your children/youth to participate in youth activities under direction of the Youth Leaders, both within and outside of Church grounds?

Yes No

Do you give permission for the Youth Leaders to authorize medical treatment for your children or youth in case of emergency, by and under the recommendation of qualified medical personnel?

Do you give St. Matthew's United Methodist Church permission to take and/or post photos and/or videos of your children/youth:

For the church website (using only first names to identify)? For church bulletin boards? For church-wide or CYF Ministries email newsletters, or to share with other families in the church? On public Youtube livestream (only first names will be used to identify)? On the church's Facebook community page, or on other social media (again, only first names will be used to identify)?

By writing my name in this box, I certify that I have read and agree to abide by St. Matthew's Safe Sanctuary Policies.

Last updated: 8/24/23

Children, Youth, and Families Registration! 2023- 2024

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