Step 1 of 5 20% Thank you for your interest in registering for "HayDay!"Please fill out this form to register your children. It should take between 2-5 minutes per child. Harvest Bible School Dates: Friday-Saturday, October 14th & 15th 6:00-8:30pm Sunday, October 16th 10:00am Trinity Christian Chapel 269 Greentree Rd, Sewell Ages Kindergarten - 6th Grade Family InformationParent Name(Required) First Last Parent/Caregiver Has A(Required)Home PhoneCell PhoneBothHome Phone(Required)Cell Phone(Required)Parent Email(Required) Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Church WAIVER OF LIABILITY & PHOTO RELEASE CONSENTWe understand the arrangement and believe that the necessary precautions and plans for the care and supervision of the child will be taken during their participation in Trinity Christian Chapel programs and/or trips. Beyond this, we will not hold responsible Trinity Christian Chapel or the person supervising the program and/or trip. In case of emergency, I understand that every effort will be made to contact me. If I cannot be reached, I hereby give the Children’s leadership, staff, or other emergency medical personnel the permission to act on my behalf in seeking emergency medical treatment for this child in the event that such treatment is deemed necessary by the volunteer, leadership, or church staff. I give permission to those administering emergency medical treatment to do so using those measures deemed necessary. I absolve Trinity Christian Chapel, and/or church personnel from Liability in acting on my behalf in this regard so long as they are not grossly negligent. I, as a parent or guardian of a child participating in Children’s Ministry programs at Trinity Christian Chapel, Sewell, NJ, accept the responsibility for all expenses arising from medical care for injuries to my children while participating in these activities. Your child/children may be photographed or filmed while participating at Trinity Christian Chapel. Their photo may be used for promoting or sharing activities from Children’s Ministry or church related events, in printed materials and/or electronically on the Internet.Parent’s or Guardian’s typed signature below indicates acceptance of these policies: Date MM slash DD slash YYYY Emergency Contact, Relationship to Child, Phone # First Child's InformationFirst Child's Name(Required) First Last First Child's Age(Required)First Child's Date Of Birth(Required) MM slash DD slash YYYY Current School Grade(Required) What allergies or medical needs should we be aware of for this child?(Required)Please explain or write "None"In case of emergency, we will contact the cell phone number listed for the parent/caregiver. If no cell phone number is listed, we will contact the home phone number listed for the parent/caregiver.Would you like to register a second child at this time?(Required) Yes No Second Child's InformationSecond Child's Name(Required) First Last Second Child's Age(Required)Second Child's Date Of Birth(Required) MM slash DD slash YYYY Current School Grade(Required) What allergies or medical needs should we be aware of for this child?(Required)Please explain or write "None"In case of emergency, we will contact the cell phone number listed for the parent/caregiver. If no cell phone number is listed, we will contact the home phone number listed for the parent/caregiver.Would you like to register a third child at this time?(Required) Yes No Third Child's Name(Required) First Last Third Child's Age(Required)Third Child's Date Of Birth(Required) MM slash DD slash YYYY Current School Grade(Required) What allergies or medical needs should we be aware of for this child?(Required)Please explain or write "None"In case of emergency, we will contact the cell phone number listed for the parent/caregiver. If no cell phone number is listed, we will contact the home phone number listed for the parent/caregiver. Δ
