11400 27 Street SE
Ph: 403.239.9099
calgarylifechurch.com
New Family Registration
Last Name: _______________________ Parents/Guardians Names: ________________________ Relationship to Child(ren): ____________
Address: ________________________________________ City: __________________ Province:__________ Postal Code: _______________
Email Address: _______________________________________________ Phone #: _____________________ Cell #:____________________
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I’d like to know more about CLC
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Please invite us to your next Welcome
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How did you hear about us_________
Lunch
INFORMED CONSENT AND WAIVER AGREEMENT:
I, the parent or guardian named above, do hereby agree to, and give permission for:
______ Program Participation: The children named herein to participate in the Calgary Life Church Children’s Ministry program (“the Program”) and
assume all risk of loss, expense, damage or injury resulting from their participation in the activities of the program, and
______ Medical Consent: do hereby give permission for all staff members of Calgary Life Church to authorize any physical or hospital to provide medical
assessment, treatment or procedures for the participant(s)
______ Media Release: Calgary Life Church to reproduce, use, exhibit, display, and broadcast, distribute and create derivative works of the photographed
or filmed images for use in connection with the activities of Calgary Life Church or for promoting, publicizing or explaining CLC or its activities. This
permission includes, without limitation, the right to publish such images to Calgary Life Church websites, in Calgary Life Church publications and in
PR/promotional materials, such as marketing and advertising. These images may appear in any of the wide variety of formats now available to Calgary Life
Church and that may be available in the future, including -- but not limited to – print, broadcast, videotape, CD_ROM and electronic/online media.
I, the parent or guardian names above, in consideration of Calgary Life Church registering the participant(s)in the program, undertake and agree as follows:
To waive any and all claims that I have or may have against Calgary Life Church, its staff members, Board of Governors, employees and volunteers, and their agents,
representatives, successors and assigns (collectively referred to as the “Releasees”), and to release the Releasees of any and from any and all losses, expenses, damages, and
claims arising out of or in connection with injury or damage suffered by the participant(s) as a result of participating in the activities of the program. And to indemnify and hold
harmless the releases from any and all liability for any loses, expenses, damages and claims arising out of or in connection with injuries or damage to any and all persons and to
any and all property, in any way sustained or alleged to have been sustained, as a result of the participant(s) engagement in the activities of the Program. This release is
effective and binding upon my heirs, next of kin, executors, administrators, assigns and representatives, in the event of my death or incapacity.
By signing below, I consent to having the information in this document collected by Calgary Life Church. This information in being collected for the purpose of enrolling your
child(ren) in the Program, to assign the child(ren) to the appropriate classes, to develop and nurture ongoing relationships with you and your child(ren) and to inform you of
Program updates and upcoming opportunities at our church. Your information is protected under the Personal Information Protection Act in the Province of Alberta.
I have read and understood this agreement and I am aware that by signing this agreement I am waiving certain legal rights which I or my
heirs, next of kin, executors, administrators, assigns and representatives may have against the Releasees.
Signed and dated this______ day of ______________ 20_____, at Calgary, Alberta.
_____________________
________________________
Signature of parent or Guardian
Printed Name of parent or Guardian
______________________
Signature of Witness
_____________________
Printed Name of Witness
Safety Information for Parents
Child Pick Up
When you signed in your child an identity tag was placed on your child and an identical parent tag was handed to you. Please carefully
keep this tag with you as it is our CLC Kids Team way of ensuring that each child returns home with the right parent. When picking up your
child(ren) simply return to their classroom and present the team with your parent tag and they will call your child and ensure that the tags
match. Should you lose your tag you will be asked to step aside until the rest of the children have been released and the CLC Kids
Coordinator will work with the team to confirm your identity (photo ID will be required)
Emergency Procedures: Don’t worry, we’ve got this.
In the event of an evacuation or lock down please calmly proceed to our Muster Point (the transit parking lot on the west side of 27 Street
SE), the CLC Kids team will care for your children and will reunite you with them there. To Ensure the safety of your child(ren), in the event
of an emergency, you will pick your child(ren) up at the Muster Point ONLY, No Children will be released from the kids wing and access will
be denied to anyone but Emergency response personelle.
11400 27 Street SE
Ph: 403.239.9099
calgarylifechurch.com
11400 27 Street SE
Ph: 403.239.9099
calgarylifechurch.com
New Family Registration
Child # 1
Name: _______________________________
M / F Birthdate: _____________________ Allergies/Medical: ______________________
Month/Day/Year
Child # 2
Name: _______________________________
M / F Birthdate: _____________________ Allergies/Medical: ______________________
Month/Day/Year
Child # 3
Name: _______________________________
M / F Birthdate: _____________________ Allergies/Medical: ______________________
Month/Day/Year
Child # 4
Name: _______________________________
M / F Birthdate: _____________________ Allergies/Medical: ______________________
Month/Day/Year
Child # 5
Name: _______________________________
M / F Birthdate: _____________________ Allergies/Medical: ______________________
Month/Day/Year
Any Special Instructions, custody concerns or anything else we should know?
__________________________________________________________________________________________________________________
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FAQ’s
Is there a security system in place?
Yes, there are a number of systems and policies in place to ensure the safety of all our children. When you check in your child(ren), you will
receive a parent tag with a 3 digit code. Should your child(ren) need you, the paging system in the sanctuary will display this 3-digit code.
You will need to present your parent tag in order to pick-up your child(ren), indicating that you have permission to pick up the child(ren).
What if I lose my parent tag?
Should you lose your tag you will be asked to step aside until the rest of the children have been released and the CLC Kids Coordinator will
work with the team to confirm your identity (photo ID will be required).
What kinds of snacks will my child be served?
Our standard snack for toddlers and pre-school children is Arrowroot and/or Oreo cookies and water. Occasionally a special snack may be
offered so it is important to let us know about any food allergies in your New Family Registration Form.
How do I get involved?
There are many exciting opportunities for serving at Calgary Life Church! Visit the Connect Centre for more information.
11400 27 Street SE
Ph: 403.239.9099
calgarylifechurch.com