Stockbridge Teen Center Registration
Crossroads Community Church
5000 S. Clinton St, Stockbridge, MI  49285

Monday - Friday  2:30pm - 5:30 pm  during the school year (following full school days, excluding holidays).
Summer schedule to be determined in May, at the end of each year.

The Stockbridge Teen Center provides a fun, safe place for students to hang out after school during the school year and periodically during the summer.  There are both indoor and outdoor activities, which are supervised by adult volunteers, such as Gaming, Ping Pong, Foosball, Air Hockey, Basketball, Volleyball, Soccer, Football, Tetherball and more.

Parent/Legal Guardian should register student(s) grades 6-12 who have permission to attend the Teen Center during regular hours of operation and/or for special events held at the Teen Center.  

If parental permission is revoked, it is the responsibility of the parent/legal guardian to inform the Teen Center Director in writing at teencenter@c3stockbridge.org.

All students who attend the Teen Center will be asked to sign in. Once a student chooses to leave the property, the Teen Center is not responsible for their safety.  Parents/legal guardians are responsible for discussing and implementing the student's expected behavior while at the Teen Center, along with the expectation of leaving the grounds before being picked up.

Teen Center Director - Bonnie Davidson
teencenter@c3stockbridge.org 
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Student (First & Last Name) *
Student's Date of Birth *
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Student's phone number *
Gender at birth *
Parent/Legal Guardian (First & Last Name) *
Parent/Legal Guardian (Phone Number) *
Relationship to Student *
Emergency Contact if different from Parent/Legal Guardian (First & Last Name & Phone #) *
Student Food/Medication Allergies or other medical concerns *
Code of Conduct:  PARENT/LEGAL GUARDIAN-(Please sign electronically below) Students are expected to cooperate with staff at all times.  No public display of affection.  Hands are expected to be kept to themselves.  Possession and/or use of alcoholic beverages and/or any type of drugs and/or weapons are strictly prohibited.  Failure to remain within these guidelines at any time could result in the student being asked to leave the Teen Center and parents/guardians being notified.  As the parent or legal guardian of the listed student above, I have read and agree with the information provided and have discussed it fully with my student(s). *
By electronically signing this section, I understand that pictures and/or videos of my child may be used in multi-media presentations, advertisements and promotional material that is generated by or for the Stockbridge Teen Center.  Discretion and sound judgment will be exhibited in the use of such photos/videos.   *
My student has permission to utilize transportation provided through the Teen Center during regular hours of operation.   *
Participation Agreement:  By signing below, I acknowledge that participation in the activity described above involves risk to the participant (and to the participant’s  parents or guardians, if the participant is a minor), and may result in injury. In consideration for the opportunity to participate in Teen Center activities, the participant (or  parent/guardian if the participant is a minor) acknowledges and accepts the risks of injury associated with participation in  and transportation to and from the activity. The participant (or parent/guardian) accepts personal financial responsibility for  any injury or other loss sustained during the activity or during transportation to and from the activity, as well as for any  medical treatment rendered to the participant that is authorized by Stockbridge Teen Center or its agents, employees, volunteers, or any  other representatives (collectively referred to as Crossroads Community Church). Further, the participant (or parent/guardian)  releases and promises to indemnify, defend, and hold harmless the activity sponsor for any injury arising directly or  indirectly out of the described activity or transportation to and from the activity, whether such injury arises out of the  negligence of the activity sponsor, the participant, or otherwise. If a dispute over this agreement or any claim for damages arises, the participant (or parent/guardian) agrees to resolve the  matter through a mutually acceptable alternative dispute resolution process. If the participant (or parent/guardian) and the  activity sponsor cannot agree upon such a process, the dispute will be submitted to a three-member arbitration panel for  resolution in accordance with the rules of the American Arbitration Association. *
Today's Date *
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Thank you for allowing your student to participate in the Stockbridge Teen Center!  For more information, contact us at teencenter@c3stockbridge.org.
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