SRF Encinitas Temple Registration Form for   Family Room, Sunday School & Teen Group
Please complete one form per child. Parents may edit and update previous responses.
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Child's First Name *
Child's Last Name *
Gender *
Child's Grade *
Number only
Child's Age *
Number only
Food allergies
 Meditation Techniques: Hong Sau (Eligible at 10 years),  Aum (Eligible at 13 years & after having Hong Sau for 1 year), Kriya (Eligible at 16 years old)                                                                                                                                                                                                                                                    
Date of Birth *
MM
/
DD
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YYYY
Parent/Guardian #1 First and Last Name *
Relationship to the Child *
#1 Cell phone number *
#1 Email address *
Parent/Guardian #2 First and Last Name
Relationship to the Child
#2 Cell phone number
#2 Email address
PARENT CONSENT & RELEASE: In consideration for our child’s participation in Sunday School/Teen Group at the Encinitas Temple, we hereby agree to release and hold Self-Realization Fellowship and its officers, directors, monastics, employees, volunteers, representatives, and agents, and Encinitas Temple monastics, employees, and volunteers, harmless from any and all liabilities, claims, damages, costs, actions, causes of actions, demands, and losses arising out of or in any way related to our child’s participation in Sunday School/Teen Group.
ELECTRONIC SIGNATURE AGREEMENT
By selecting the "submit" button below, you are signing this Agreement electronically. You agree your full name signature is the legal equivalent of your manual signature on this Agreement. Thank you.              
Please type your full name. *
 OPTIONAL PHOTO WAIVER RELEASE  We give to Self-Realization Fellowship, all monastic personnel, Youth Services personnel from Mother Center, and the Sunday school/Teen Group volunteer staff of the Encinitas Temple our permission to take any of the following actions in connection with our child’s participation in Sunday School or teen group:                                                             To videotape and/or take photographs of our child, alone or with others, participating in Sunday School/Teen Group activities at any one or more of SRF’s temples or properties, To use and reuse, in any manner determined appropriate in SRF’s sole discretion, such videotapes and/or photos, in whole or in part, modified or altered, either by themselves or in conjunction with other photographs, in any medium or form, for such purposes as determined appropriate by SRF. To use my child’s name in connection with the use or reuse of such videotapes and/or photographs, to use our child’s verbal and written statements of a spiritual nature solely to encourage others on the spiritual path, and to copyright such videotapes, and/or photographs in SRF’s name or in any other name SRF chooses.                                              
Please type yes if you permit your child to be photographed. Please type No if you do not allow. *
Teen Parent, do Teen Group leaders have permission to contact your teen?
If yes, please add Teen's cell number and email address.
Anything else you would like your child's teacher to know?
Child's primary address *
Volunteer Opportunities - Parents, are you interested in helping our Encinitas Temple with organizing or participating in family friendly activities and special events?
If you selected 'YES', please go to the Encinitas Temple website and fill in the Volunteer Form (http://encinitastemple.org/volunteer/). There are many ways to help such as Special Events, Teaching, Assisting, Craft Room Staff, Office Staff, Craft Making and other positions. After filling in form please let us know your interests and availability at encinitasyouthcommittee@gmail.org.
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