2023-2024 Pathway Youth Registration

Pathway Life Church is collecting and retaining this personal information for the purpose of enrolling your child/student in our programs, to assign them to the appropriate group, to develop ongoing relationships with you and your child/student, and to inform you of program updates and upcoming opportunities

Student Info

First Name *

Last Name *

Date of Birth *

School Grade (as of Sep 2023) *

Gender

Mailing Address

Mailing Address Line 2

Mailing City

Mailing Postal Code

Mobile Number

Email Address

Student Medical Info

The safety of your child/student is our primary concern. Precautions will be taken for their well-being and protection.

Information received is confidential and is being gathered for the purposes of serving your child/student while in the care of Pathway Life Church. Any medical information collected here serves to authorize Pathway Life Church, and its staff and volunteers, to obtain medical assistance in emergencies on their behalf.

Medical / Allergy

Please list any medications your child/student will be bringing with him/her:

Please list any physical, emotional or behavioural concerns/limitations that our staff should be aware of:

Parent/Guardian Contact Info

Parent/Guardian #1

First Name *

Last Name *

Mobile *

Email *

Relationship to Student *

Parent/Guardian #2

First Name

Last Name

Mobile

Relationship to Student

Weekly Parent Email

The weekly parent email is a key way to communicate youth dates and locations throughout the year. Subscribe to the parent email newsletter below and/or follow us @pathwayquestdrive on Instagram for more.

Add your email below to subscribe to the parent newsletter

Communication with Students

Our Quest/Drive staff and leaders want to create a safe place and care on a personal level for each teen as appropriate, as we partner with you as parents. Let us know the form(s) of communication that Pathway Youth staff and program leaders may communicate with your teen (check any/all that apply).

Leader/Student Communication *

Cell phone (text, calls)

Social media

None of the above

Media Consent

Photographs and / or video footage may be used for future youth programs or sunday services, on our website, brochures, and social media pages. Personal information will never be displayed with any image (ie. name, age).

Let us know which uses you consent to by clicking any/all that apply

If your child could be on a team with any other student who attends Pathway Youth, who would it be? (optional)

Parent / Guardian Consent:

I have read, understood and agree with the above and sign it to cover all Youth Ministry activities for the program year effective September 2023 to August 2024, including large group gatherings and small group activities in host homes/parks/public spaces. A separate Informed Letter of Consent will be required for your child/student to participate in activities of elevated risk (trips, retreat, etc).

I/we authorize Pathway Life Church staff and/or volunteers to sign a consent for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for my/our child/student listed above.

I/we undertake and agree to indemnify and hold harmless ministry personnel, Pathway Life Church, and its volunteers from and against any loss, damage or injury suffered by the participant as a result of being part of the activities of Pathway Life Church, as well as of any medical treatment authorized by the supervising individuals representing Pathway Life Church. This consent and authorization is effective only when participating in or traveling to events sponsored by Pathway Life Church.

Name of Parent Giving Permission *

Date of Permission *