Gospel Centre Bible Quizzing Registration

Student's Information

Name

Phone

Address

Birthdate

Alberta Health Card Number

School

Grade

Gender

Female Male

Allergies - Does this student have any allergies that we should be aware of? Please list them below:

Do you have any special instructions or physical, emotional, mental, or behavioral concerns/limitations for this student that we should be aware of?

How did you hear about Bible Quizzing?

Parent/Guardian's Information

First Parent/Guardian's Full Name

First Parent/Guardian's Cell Phone

First Parent/Guardian's Email

This address will receive a confirmation email

Address (if different than above)

Second Parent/Guardian's Full Name

Second Parent/Guardian's Cell Phone

Second Parent/Guardian's Email

Second Parent/Guardian's Address (if different than above)

General Info, Permissions & Legal Consent

What church do you attend? If you don't attend church, enter "none."

Would you like to be involved with our Bible Quiz team in any of the following areas? Check all that you are interested in. Prayer Small Group Leader Set up Take Down Sanitization

PERMISSION: Do we have your permission to follow up with your student via text?

Yes No

INFORMED CONSENT: In the event of an emergency I grant permission for my child to be examined by a physician or nurse in case of accident or illness if taken to an emergency room. I understand I will be contacted immediately. Further, I will hold harmless or indemnify Gospel Centre Pentecostal Church for any loss or injury that may be sustained. I recognize that there are risks inherent in activities my child may be engaged in and, again, I waive, hold harmless, or indemnify Gospel Centre Pentecostal Church, its instructors, paid or volunteer staff, successors, heirs, and assigns from any action.

Informed Consent

Yes No

Parent/Guardian Signature

Date Signed

WAIVER: I hereby give permission for my child to be photographed and/or filmed without any reimbursement of any kind due to me or the need to pay any fee. Gospel Centre Pentecostal Church considers all information personal and confidential and will only use it within the church for ministry or other church related activities and will not release it to outside parties or organizations.

Yes No

Parent/Guardian Signature

Date Signed

Emergency Contact Info

Emergency Contact Name

Emergency Contact Phone Number

Doctor's Name

Doctor's Phone Number

Gospel Centre Pentecostal Church considers all personal information as confidential and will not release it to outside parties or organizations. However, by completing this form, you are providing consent for this information to be used within the church for ministry and other church related activities. when using photos of Gospel Centre events, either on our website or on Gospel Centre's Facebook page, we try to post photos that would not be considered objectionable. We will remove any photo immediately upon request.

Gospel Centre Bible Quizzing Registration

Description

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