Millarville Community Church (MCC) Sunday School Registration Form Bundle

This registration bundle includes forms 2, 4 and Appendix A from the MCC Plan to Protect for the current year.

Sunday School Registration

This Portion to be completed by parent or guardian:

Parent/Guardian (1) First and Last Name

Parent/Guardian (1) Contact Phone Number

Parent/Guardian (1) Contact E-mail

Parent/Guardian (2) First and Last Name

Parent/Guardian (2) Contact Phone Number (if different from above)

Multi-line address

Country/Region

Address

City

Zip / Postal code

Child #1's name (include last name if different from Parent/Guardian)

Child #1's grade

Child #1's birth date

Month

Day

Year

Child #1's medical conditions; dietary needs; physical, emotional, or behavioral concerns or limitations; phobias; and/or allergies

If your child brings medication with him/her, please list:

Child #1 Alberta Health Care #

Child #2's name (include last name if different from Parent/Guardian)

Child #2's grade

Child #2's birth date

Month

Day

Year

Child #2's special needs, medical conditions, dietary needs, phobias and/or allergies

If your child brings medication with him/her, please list:

Child #2 Alberta Health Care #

Child #3's name (include last name if different from Parent/Guardian)

Child #3's grade

Child #3's birth date

Month

Day

Year

Child #3's special needs, medical conditions, dietary needs, phobias and/or allergies

If your child brings medication with him/her, please list:

Child #3 Alberta Health Care #

Child #4's name (include last name if different from Parent/Guardian)

Child #4's grade

Child #4's birth date

Month

Day

Year

Child #4's special needs, medical conditions, dietary needs, phobias and/or allergies

If your child brings medication with him/her, please list:

Child #4 Alberta Health Care #

Child #5's name (include last name if different from Parent/Guardian)

Child #5's birth date

Month

Day

Year

Child #5's grade

Child #5's special needs, medical conditions, dietary needs, phobias and/or allergies

If your child brings medication with him/her, please list:

Child #5 Alberta Health Care #

For families registering more than 5 children, please fill-out a second form.

From time to time, photographs and short videos of activities are taken for use within the church community, in slideshows presented in the building and for possible publication including the church website, printed materials of MCC, as well as social media (e.g., Facebook, YouTube). No names or personal details will be used in any of our printed materials, website publications or on social media.

Please check those you permit:

Slideshows in MCC (e.g., presented at Sunday Service)

MCC Website

Printed materials

Social Media

I/we the parent(s) or guardian(s) of the child(ren) named above give consent to my child(ren) joining and participating in children's education programs (e.g., Sunday School) and related events at Millarville Community Church.

I/we authorize Millarville Community Church staff to consent for medical assessment, treatment or procedures for the participant(s) named above. I/we agree to any emergency treatment to be given as considered necessary and authorize Millarville Community Church staff/ministry leaders to sign consent for medial treatment or procedures for the participant(s) named above. I/we agree to indemnify and hold blameless Millarville Community Church, its staff, volunteers and representatives from and against any loss, damage or injury suffered by the participant(s) as a result of being part of the activities of the Millarville Community Church, as well as any medical treatment authorized by the supervising individuals representing the church. This consent and authorization is effective only when participating in or traveling to and from events of the Millarville Community Church.

In the case of custody agreements, please include the proper form authorizing parental contacts. Information received is confidential unless required by first responders and/or medical professionals.

NB The medical profession takes the view that a parent's consent to medical treatment can not be delegated. Medical consent forms have no legal status and a doctor has the right to insist parental consent before treating a child. We have found however, that medical staff find this type of general consent helpful.

We recognize that circumstances/information changes and if it does it is the responsibility of the parent/guardian to make the organizers aware in writing so that changes can be made to the existing form or a new form can be completed.

I agree to the terms & conditions above

Signature Section

To be signed by the Parent/Guardian

Parent/Guardian's Signature

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Signed By:

Today's Date

Month

Day

Year

Millarville Community Church (MCC) Sunday School Registration Form Bundle

This registration bundle includes forms 2, 4 and Appendix A from the MCC Plan to Protect for the current year.

Sunday School Registration

This Portion to be completed by parent or guardian:

Parent/Guardian (1) First and Last Name

Parent/Guardian (1) Contact Phone Number

Parent/Guardian (1) Contact E-mail

Parent/Guardian (2) First and Last Name

Parent/Guardian (2) Contact Phone Number (if different from above)

Multi-line address

Country/Region

Address

City

Zip / Postal code

Child #1's name (include last name if different from Parent/Guardian)

Child #1's grade

Child #1's birth date

Month

Day

Year

Child #1's medical conditions; dietary needs; physical, emotional, or behavioral concerns or limitations; phobias; and/or allergies

If your child brings medication with him/her, please list:

Child #1 Alberta Health Care #

Child #2's name (include last name if different from Parent/Guardian)

Child #2's grade

Child #2's birth date

Month

Day

Year

Child #2's special needs, medical conditions, dietary needs, phobias and/or allergies

If your child brings medication with him/her, please list:

Child #2 Alberta Health Care #

Child #3's name (include last name if different from Parent/Guardian)

Child #3's grade

Child #3's birth date

Month

Day

Year

Child #3's special needs, medical conditions, dietary needs, phobias and/or allergies

If your child brings medication with him/her, please list:

Child #3 Alberta Health Care #

Child #4's name (include last name if different from Parent/Guardian)

Child #4's grade

Child #4's birth date

Month

Day

Year

Child #4's special needs, medical conditions, dietary needs, phobias and/or allergies

If your child brings medication with him/her, please list:

Child #4 Alberta Health Care #

Child #5's name (include last name if different from Parent/Guardian)

Child #5's birth date

Month

Day

Year

Child #5's grade

Child #5's special needs, medical conditions, dietary needs, phobias and/or allergies

If your child brings medication with him/her, please list:

Child #5 Alberta Health Care #

For families registering more than 5 children, please fill-out a second form.

Please check those you permit:

Slideshows in MCC (e.g., presented at Sunday Service)

MCC Website

Printed materials

Social Media

In the case of custody agreements, please include the proper form authorizing parental contacts. Information received is confidential unless required by first responders and/or medical professionals.

I agree to the terms & conditions above

Signature Section

To be signed by the Parent/Guardian

Parent/Guardian's Signature

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Signed By:

Today's Date

Month

Day

Year