St. Andrew Kim Youth Ministry
Life Teen Registration Form
Sign in to Google to save your progress. Learn more
Name (Full Name) *
Korean Name
Baptismal Name/세레명
Grade *
Gender
Clear selection
Cell # *
Email *
Instagram ID *
School Name *
Allergies and Dietary Restrictions
Parent/Guardian Information
Full Name *
Relationship with Participant *
Cell # *
Email *
Address *
Agreement and Permission
Model ReIease Statement: I hereby grant permission for my child to be photographed and/or videotaped during Life Teen Activities and events. I understand that my child may decline to be photographed and/or videotaped at any time. I further grant permission for the resulting photographs and/or videotaped footage to be edited, if necessary, and then published and/or used for the purpose of promoting Life Teen and/or youth programs at St Andrew Kim Catholic Church. *
I/We understand that reasonable precautions will be taken to safeguard the health and safety of the participant and that the parent or guardian will be notified as soon as possible in case of an emergency. In the event of any sickness or accident person(s) will not hold St Andrew Kim Church, the Archdiocese of Toronto, any volunteer, chaperone, or driver responsible. I/We authorize and consent that emergency treatment be rendered under the general or specific supervision and on the advice of any physician, dentist, or surgeon; licensed to practice in the Province of Ontario of any other Province. The undersigned understand(s) and agrees that any medical, dental, or hospital expense incurred shall be at their own risk. The undersigned understand(s) every effort will be made to notify the emergency contact if treatment is necessary. *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms