GNTeens/Rangers

Application Submission Form (2020-2021)

In case of an Emergency, if we cannot reach the parents, who would be the best person to contact other than yourself?

Do you give your permission to photograph your child individually or in a group or in a group and putting the photos onto our website/facebook/instagram?

  • Child's Info
  • Father's Contact Info
  • Mother's Contact Info
  • Emergency Contact
  • Privacy & Health

First & Last Name

Child's First & Last Name

Date of Birth

Phone Number

Email

Child's Home Address

School Grade

Upload Child's Photo for Verification

Max. size: 128.0 MB

Father's First & Last Name

Father's First & Last Name

Father's Phone Number

Father's Email

Best way to reach

Father's First & Last Name

Mother's First & Last Name

Mother's Phone Number

Mother's Email

Best way to reach

Emergency Contact First & Last Name

Emergency Contact First & Last Name

Emergency Contact Phone Number

Emergency Contact Email

Relationship to the Child (Aunt, Uncle, Family Friend, etc.)

Privacy Protection:

Do you give your permission to photograph your child individually or in a group and putting the photos onto our website/facebook/instagram?

Allergies / Health Issues:

Does your child have allergies/health problems we should be aware of?

Do you give your permission for your child to participate in physical activities?

Does your child have any physical or psychological issues?

If your child has physical health issues, please sign a waiver of exclusion from physical activity

If you answered YES to the last question, please list what allergies or health issues we need to be aware of:

Confirmation

Name of Person Filling Out Form

Please read our terms and AGREE before submitting form: I understand that the program of Rangers is planned out till the end of May, 2021 and that my son should not miss the group more than 3 times (without a good reason). I acknowledge that if my child has more than 3 no-call, no-show occurrences, he will be excluded from the group until the beginning of a new Rangers year in September, when he will be able to re-apply. I am aware that my son must participate in combined youth services at Good News Christian Church once a month, on the second Sunday of each month. I give my permission for my son to actively participate in mandatory work days. I confirm that the information in this application is true and accurate.