GNTeens/Rangers

Application Submission Form (2022-2023)

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: 256.0 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: 1. I understand that the Rangers program is planned through the end of May 2023 and that my son/sons should not miss the group more than 3 times during the year program without a good/proper reason. 2. 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 until September, when he will be able to re-apply. 3. I am aware that the monthly fee cost is $40.00 per one boy (who will be attending the group, this monthly fee does not change, unless there is more than one boy per family attending. In that case, the second boy is an additional fee charge of $20.00 and the third boy has an additional charge of $10.00). The fees are to be paid in full, on the first Friday of the month. 4. The Rangers event takes place every Friday from 6:30 - 8:30 pm. 5. Every last Sunday from 12:00 am to 2:00 pm Rangers is participating in the Combined Young Generation service (it is required for every Rangers participant to be part of the this service). I understand that if my son/sons will fail to attend this service, the paragraph 2 above shall apply. 6. I understand that I am “the Parent” is responsible for my daughter/daughters attendance of the Combined Young Generation service, every last Sunday of the month. 7. I give permission to my son/sons to participate in the structure of the Biblical principals which is the core foundation of the Rangers program. I confirm, that I understand the above terms required by Rangers and that the information in this application is true and accurate.