Medical Waiver & Consent

Base Profile · First Pres Youth

Youth Info

Guardian

Emergency

Activity & Risk

Final

Volunteer

Participant Information

Basic details about the participant

Participant Type *

First Name *

Last Name *

Date of Birth *

Age

Gender *

Phone Number

School Grade (this September) *

Auto-filled from date of birth (Ontario: JK the year your child turns 4). Change only if needed.

Which programs does your child participate in? Select your child's grade above to see the programs open to them.

Sunday SchoolYouth GroupOther Activities

Street Address

City

Province

Postal Code

Known Allergies *

If no known allergies, please write N/A

Dietary Restrictions *

If no dietary restrictions, please write N/A

Step 1 of 6

This information is collected securely and is only accessible to authorized program staff.