Club430 Youth Enrollment Form

Welcome! We are excited that you want to be a part of St. John's Place of Grace youth group Club430!

Child's Information

Child's first name

Child's last name

Date of birth

Month

Day

Year

Child's age

Special needs

Food allergies

Parent / Guardian Information

Parent/guardian first name

Parent/guardian last name

Home address

Country/Region

Address

City

Zip / Postal code

Email address

Phone number

I grant permission for my minor child to participate in church services and related activities.

I acknowledge that my child’s participation in church services, fellowship meals, outdoor gatherings, ministry activities, and special events is voluntary.

I understand that photos and videos may be taken during services and events for ministry purposes, including:

Church website
Social media
Promotional materials
Livestreams

I grant St. John’s Place of Grace Church permission to use images or video of me (or my minor child) for ministry-related purposes unless I submit a written opt-out request.

To the fullest extent permitted by California law, I agree that St. John’s Place of Grace Church, its pastors, board members, volunteers, and representatives shall not be held liable for injuries or damages arising from ordinary participation in church activities, except in cases of gross negligence or willful misconduct.