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Pioneer Clubs Registration

Address*

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Please enter child information below. If you have multiple children to register, please complete a form separately for each one.

Child’s Gender*

Please provide child's birthday.

as of this Fall's school year.

Enter “none” if you do not have one.

Participation Waiver*

By registering, I give permission for my child to participate in this program sponsored by Faith Presbyterian Church. I fully understand that his/her participation may entail the risk of physical injury. I agree to waive any claim of any kind whatsoever, whether resulting from an injury or otherwise, and further agree to release, indemnify, and hold harmless the program, Faith Presbyterian Church, and their respective directors, officers, employees, agents and/or representatives from any and all liability occurring as a result of his/her participation in the program. I will be personally responsible for any financial costs incurred as a result of his/her participation in the program, including, without limitation, transportation and/or medical expenses incurred as a result of any injury.

Photography Waiver*

Faith Church will periodically take pictures of the children in their classrooms, at play, during events, or of special projects. These photographs may be used for flyers, brochures, slideshows, or website/social media promotions and announcements.