The Grove – Registration – Calvary Pentecostal Church

The Grove is Calvary’s Sunday School for kids ages 1–12, where children discover God’s love through worship, Bible lessons, and fun activities in a safe, nurturing environment. Meeting every Sunday from 10:30 –11:30 AM during the morning service, families can check in their children in the lower level before class begins. Our fully screened and trained volunteers ensure a secure and welcoming space. Whether you’re new to Calvary or just visiting, your kids are always invited to join the fun, build friendships, and grow in faith at The Grove.

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Calvary Pentecostal Church Children’s Ministry

Registration and Medical Consent Form

Information received is confidential and is being gathered to serve your Child while in the care of Calvary Pentecostal Church. Any medical information collected here serves to authorize Calvary Pentecostal Church, its staff and volunteers to obtain medical assistance in emergencies.

For the school year 2025 / 2026

In the case of custody agreements, please include the proper form authorizing Parental contacts.

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Student’s Name

Date of Birth (YYYY-MM-DD)

Address

Parent/Guardian’s Name

Phone Number

Child’s Health Card #

Preferred Method of Contact

If you are needed by your child during the service, please let us know how you would prefer to be contacted. (Select all that apply)

Text

Call

Send someone to get me if I am in the building

Family Doctor

Phone Number

Allergies

In case of an emergency, contact:

Does your child have any physical, emotional, mental, or behavioural concerns or limitations that staff/ volunteers should be aware of?

Yes

If yes, please explain:

Is your child fully toilet-trained and no longer using diapers?

Yes

No*

*If you answered NO, please note that you must remain on-site to assist your child with toileting if needed.

I Understand

Alternate Authorized Pickup Person(s)

Name #1

Phone #1

Name #2

Phone #2

Name #3

Phone #3

Is your child bringing any medication with them?

Yes

If yes, please list:

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

Photos

I grant permission for my child to be photographed or videotaped, provided that no last names are published to protect privacy in the promotion of Calvary Pentecostal Church. We believe it is important to capture group memories that we can look back on and share with our church family.

I/we, the parents or guardians named below, authorize Pastor Luke Benjamin or one of Calvary Pentecostal Church’s Ministry Personnel to sign a consent for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for the participant named above.

I/we, named below, undertake and agree to indemnify and hold harmless Ministry Personnel, Organization, and its Leaders from and against any loss, damage or injury suffered by the participant as a result of being part of the activities of Organization, as well as of any medical treatment authorized by the supervising individuals representing Organization. This consent and authorization are effective only when participating in or travelling to events sponsored by Calvary Pentecostal Church.

Purposes and Extent

Calvary Pentecostal Church is collecting and retaining this personal information for the purpose of enrolling your child in our programs, to assign the student to the appropriate classes, to develop and nurture ongoing relationships with you and your child, and to inform you of program updates and upcoming opportunities at our organization. This information will be maintained indefinitely as it is a requirement of our insurance company and legal counsel. If you wish for Calvary Pentecostal Church to limit the information collected, or to view your child’s information, please contact us.

Parent/Guardian Options

I have read, understood and agree with the above and sign it to cover all Children/Youth Program activities for the program year, effective as stated below. A separate Letter of Informed Consent will be sent home for off-site activities and activities of elevated risk.

Signature

* By typing your full name below, you agree that this serves as your legal signature and that you give consent for your child to participate *

Date (YYYY-MM-DD)

I agree that typing my name serves as a legal signature