Junior Church Parent Consent
(Long Form)

As part of our commitment to keeping your children safe, we ask that any child or youth who is participating in a Calvary Gravenhurst program fill out the following form. Information received is confidential and is being gathered for the purposes of serving your children while in our care. Any medical information collected here serves to authorize Calvary Gravenhurst, and its staff and volunteers, to obtain medical assistance in emergencies. 

We recognize that circumstances change.  Please inform Calvary Gravenhurst in writing of these changes as soon as possible, so that we can maintain current records for your family. If you have any questions, please contact Pastor Mark Hockley by email at mark@calvarygravenhurst.com.

This form must be complete separately for each child. Click below to complete the form. 

Participant/Family Information
Program Selection *
Child's Full Name *
Child's Full Name
Parent 1 Full Name *
Parent 1 Full Name
Parent 2 Full Name
Parent 2 Full Name
Address *
Address
Primary Phone Number *
Primary Phone Number
Secondary Phone Number
Secondary Phone Number
Date of Birth *
Date of Birth
Which school grade is your child in this year?
Emergency Contact Information
Full Name *
Full Name
Primary Phone Number *
Primary Phone Number
Secondary Phone Number
Secondary Phone Number
Medical Information
Does the child you are registering have any allergies, dietary concerns, medical conditions or disabilities that we need to be aware of? *
Family Doctor's Name *
Family Doctor's Name
Consent and Parental Agreement
Please read the following conditions carefully, and contact the church if you have any questions.
Medical Release *
The safety of your child is our primary concern. Precautions will be taken for their well-being and protection. I agree to any emergency treatment to be given as considered necessary. I undertake and agree to indemnify and hold harmless Calvary Gravenhurst and its leaders from and against any loss, damage or injury suffered by the participant as a result of being part of the activities of Calvary Gravenhurst, as well as of any medical treatment authorized by the supervising individuals representing Calvary Gravenhurst. This consent and authorization is effective only when participating in to events sponsored by Calvary Gravenhurst.
Ministry Care Release *
Calvary Gravenhurst believes in excellence in our entire Children’s Ministry Department. It is always our endeavour to care for your child(ren) to the best of our ability while they are entrusted to us. At any time, we reserve the right to not admit your child into the classroom should there be signs of any communicable disease or sickness i.e. colds etc. Your child(ren) will only be released to the parent/guardian and/or those whom you have authorized above.
Media Release *
I agree to photographs and short videos of activities including my child to be taken for use within the church community and for possible publication.
Digital Signature *
Digital Signature
I have read, understood and agree with above and sign it to cover all Children’s Ministry Program activities for the program year effective as stated below I give consent to my child taking part in the programs selected above, group social events and group Sunday morning events during the service. I understand that if any information on this form changes, it is my responsibility as a parent/guardian to make the organizers aware in writing so that changes can be made to Calvary Gravenhurst's database.
Date *
Date