Route 45 Kids Registration & Medical Release

Below is a place where you can register your 4th or 5th grade student for the Route 45 Kids program.
Route 45 Kids is here to give pre-teens a place to belong. But more than that it is designed to provide them with tools to help them as they grow and live their lives. It provides teaching on what it means to be a disciple of Jesus Christ, as well as to develop character. Every student should have the foundation that this program brings both in their faith and in their life.
Wednesdays 4:00-5:15 Doors open at 3:30
1) For your child's safety and our knowledge
2) Does your child have allergies to
3) Does your child suffer from or has ever experienced or is being treated currently for any of the following
5) Does your child wear

Event Rules

For your information, we expect each student to conform to these rules of conduct 1) No possession or use of alcohol, drugs, or tobacco 2) No students can drive 3) No fighting, weapons, fireworks, lighters, or explosives 4) No offensive or immodest clothing 5) No boys in girls’ sleeping quarters and no girls in boys’ sleeping quarters, without proper adult supervision. 6) Participation with the group is expected 7) Respect property 8) Respect one another, staff, and adult leaders 9) Respect and comply with event schedules and rulesStudents who fail to comply with these expectations may be sent home at their parents’ expense.

Student Contract

I, the student, have read the rules of conduct, the above evaluation of my health, and permission to participate in youth group activities. I agree to abide by the stated personal limitations and code of conduct.

Parental Agreement

Activities may include, but are not limited to: cookouts, boating, water skiing, swimming, basketball, rollerskating, rollerblading, games in the park, soccer, broomball, ice skating, volleyball, softball, baseball, camping, downhill skiing, snowboarding, hiking, biking, concerts, Bible studies, golfing, miniature golf, hayrides. Note: If you desire to limit your child’s participation in any event, please submit your wishes in writing to the church youth pastor prior to that event.I consent that the student named above has my permission to attend all youth activities sponsored by Amazing Grace Church(hereinafter the “Church”) from
This consent form gives permission to seek whatever medical attention is deemed necessary, and releases the Church and its staff of any liability against personal losses of named child.
I/We the undersigned have legal custody of the student named above, a minor, and have given our consent for him/her to attend events being organized by the Church. I/We understand that there are inherent risks involved in any ministry or athletic event, and I/we hereby release the Church, its pastors, employees, agents, and volunteer workers from any and all liability for any injury, loss, or damage to person or property that may occur during the course of my/our child’s involvement. In the event that he/she is injured and requires the attention of a doctor, I/we consent to any reasonable medical treatment as deemed necessary by a licensed physician. In the event treatment is required from a physician and/or hospital personnel designated by the Church, I/we agree to hold such person free and harmless of any claims, demands, or suits for damages arising from the giving of such consent. I/We also acknowledge that we will be ultimately responsible for the cost of any medical care should the cost of that medical care not be reimbursed by the health insurance provider. Further, I/we affirm that the health insurance information provided above is accurate at this date and will, to the best of my/our knowledge, still be in force for the student named above. I/we also agree to bring my/our child home at my/our own expense should they become ill or if deemed necessary by the student ministries staff member.
I also give consent for the church to use images of my student captured on any events covered by this form to be used for publicity purposes in all print and digital venues.
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