ARK School Registration 2023-24

Child's Information

Child's Name

Child's Date of Birth (dd-mm-yyyy)

Notes: (Allergies, Medications, etc)

Parent's Information

Parent / Guardian Full Name

This address will receive a confirmation email

Phone

Address

Emergency Contact (name & phone #)

Applicant Information

Do you play or are you learning an instrument? Please list instrument(s) and any formal training.

Do you like to sing?

Have you made Jesus your personal Lord and Saviour? Please describe when/how that happened.

Where do you go to church?

I/we, the parent(s) or guardian(s) named above give permission for my child named on the form to attend and participate in ARK School of Prophetic Worship at King’s Gate Church for the period of October 2023 - June 2024. I do hereby release, forever discharge, and agree to hold harmless King’s Gate Church, its pastors, directors, employees, volunteers, and teachers (collectively herein the “Church”) from any and all liability, claims, or demands for accidental personal injury, sickness, or death, as well as property damage and expenses, of any nature whatsoever, which may be incurred by the undersigned and the Participant while involved in the ARK School. I, the parent or legal guardian of this Participant, hereby grant my permission for the Participant to participate fully in the ARK school activities. Furthermore, I, on behalf of my minor Participant, hereby assume all risk of accidental personal injury, sickness, death, damage, and expense as a result of participation in activities involved therein.

Checking this box is the same as applying a signature to this form. By checking this box you are agreeing that all information on this form is correct and complete and agreeing to the above waiver.

Media Release: I hereby authorize and grant permission to King's Gate Church to use my child's photographic image for any electronic or non-electronic form or media. I agree that my child's image may be reproduced, edited and used in whole or in part for any and all media used by the church including, without limitation, print, web, audio-visual, and/or multimedia purposes. Checking this box is the same as applying a signature to this form. Accept

Payment $30 CAD

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

ARK School Registration 2023-24

Description

Please Fix the Following