All Saints Church
Pasadena,CA

Registration Form
Review
Receipt

CYF Registration Form 2016-17

= Required

Your Contact Information

Parent/Guardian 1






Parent/Guardian 2






Emergency Contact (other than listed above)

Community Agreement for Participants 4-18 Years Old

We Agree:

To conduct ourselves as representatives of the All Saints community and its values, respecting each other’s differences and contributions.
To use language and behave in a manner that is acceptable to other participants and adults.
To honor the needs and property of other participants and adults.
To respect the property of the church and other facilities we use, which includes not hanging on or climbing trees, not using skateboards, scooters and skates on the property, and not engaging in any violent or destructive behavior (including the possession of weapons, excessive/aggressive swearing or language, kicking, hitting, etc).
To communicate our needs, or the observed needs or others, to group leaders.
To remain on campus under adult supervision until given parental permission to leave.
To abide by my parents’/guardians’ expectations of my behavior at on-campus events.
To not bring, or use, alcohol, tobacco, or any illegal drugs on campus.
To turn off all cell phones, iPods, and other electronic devices during rehearsals, services, or programs.

Parental Agreement for Children from Birth to 4 Years Old

I Agree:

To sign my child in and out each time we are here for childcare or Sunday School.
To remain on the All Saints Church campus whenever my child is on campus.
To keep my child at home when s/he exhibits signs of illness.
We/I understand that these agreements are designed to provide a safe and supportive community at all events. We also understand that if a participant breaks one of these agreements, s/he will have broken the trust of the community, and may be asked to leave at the expense of the child’s parent(s)/guardian(s).

Media and Photo Release:

I hereby give permission for this parish to use my child’s photograph (without their name) in parish publications, on the parish website and in news releases in regard to any parish sponsored activity.





Participant 1 Information






Medical Authorization and Health History for Participant 1

All Saints Church has a strong commitment to provide inclusive programs that can be responsive to the individual needs of each child who attends.
By better understanding your child's unique strenghts and challenges, we can provide better support for building a stong community of youth and children. The insights you share can help ensure a rich experience for everyone.
I/we the parent(s) or legal guardians(s) of the above indicated (Participant 1), hereby authorize and consent to any x-ray examination, anesthetic, medical or surgical diagnosis or treatment and hospital care which is deemed advisable by, and is to be rendered under the general or special supervision of any licensed medical personnel on staff of any licensed hospital.
This authorization is given in advance of any specific diagnosis, treatment, or hospital care required, but is given to provide authority and power to render care, which is deemed advisable in the best judgement of the physician.

Medication Information for Participant 1



If "YES", please answer the following questions:






*Staff CANNOT administer medication.













Participant 2 Information






Medical Authorization and Health History for Participant 2

All Saints Church has a strong commitment to provide inclusive programs that can be responsive to the individual needs of each child who attends.
By better understanding your child's unique strenghts and challenges, we can provide better support for building a stong community of youth and children. The insights you share can help ensure a rich experience for everyone.
I/we the parent(s) or legal guardians(s) of the above indicated (Participant 2), hereby authorize and consent to any x-ray examination, anesthetic, medical or surgical diagnosis or treatment and hospital care which is deemed advisable by, and is to be rendered under the general or special supervision of any licensed medical personnel on staff of any licensed hospital.
This authorization is given in advance of any specific diagnosis, treatment, or hospital care required, but is given to provide authority and power to render care, which is deemed advisable in the best judgement of the physician.

Medication Information for Participant 2



If "YES", please answer the following questions:






*Staff CANNOT administer medication.













Our systems disallows us to accept more than two children per registration form. If you have more than two children, please complete this registration for your first two and complete another registration for the other(s). We apologize for the inconvenience.

Please fill out this portion ONLY if you are signing up your child(ren) for Children's and Youth Choirs.

Enrollment fees for participation in the 2016-2017 children and youth choir program at All Saints Church have two categories:
-- There is no enrollment fee for pledging families. Pledging families who desire to contribute additional funds toward the youth choir program, in support of scholarships and to help offset program expenses, may do so by contacting Jenny Tisi or the Giving Office.
-- The enrollment fee for non-pledging families is $300 per chorister. Additional siblings in the same family receive a $50 discount.
-- Scholarships are available to those who need assistance with enrollment fees. Please contact Jenny Tisi for more information.
PK-K Minisingers / 1-2 Mastersingers / 3-5 Troubadours / 6-12 Trouveres

Pledging Family

Total due for pledging families: $0.00
(USD)

Non-Pledging Family

(USD)

All chorister families should plan to attend Registration Day at All Saints Church on Sunday, September 11 from 8:30 am - 1:00 pm to sign up for mandatory volunteer shifts.

Event Information
  • 6/30/2017
Contact Information
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