2017/18 CCC Church School/Youth Programs Registration Form

The information on this form will be used to assemble and create the CCC Church School/Youth Programs rosters. We appreciate your partnership with us to help ensure that CCC activities are safe and rewarding for our children. Please submit a separate form for EACH of your children, (Nursery through 12th grade).

Student Contact Information

Student NAME

Student BIRTHDATE

Primary Contact Parent/Guardian NAME

Primary Contact Parent/Guardian EMAIL

Primary Contact Parent/Guardian PHONE #

Secondary Contact Parent/Guardian NAME

Secondary Contact Parent/Guardian EMAIL

Secondary Contact Parent/Guardian PHONE #

Student's Emergency Contact NAME

Emergency Contact's PHONE #

Emergency Contact Relationship to Child

Student's HOME ADDRESS

Student PHONE #

Student EMAIL

Student Class Information

Please indicate which class your child will enter this school year.
Please note that the preschool classes are designed to keep children together with the cohort with which they will enter kindergarten. Potty training is preferred for the Little Lambs class, but we can be flexible with arrangements on a case by case basis.

School Attending

Student Medical Information

We feel strongly at CCC the need to welcome and care for each child and whatever special needs they may have. We ask the following questions so that we may provide the best experience and safest environment for your child and their classmates and teachers. Our church and our childrens/youth ministry volunteers respect your family’s right to privacy. We will communicate any information from this form only with those directly caring for your child and only on a “need to know” basis. Volunteers are obligated to keep this information confidential. Please answer the following questions that apply to your child so that our church may best minister to your child. If for any reason you would rather share this information verbally, please contact the church office and someone from the Christian Education/Youth team will contact you.
Please write "None" if you have no concerns to share.

Student's Allergies & Medical Needs

NO: My child has NO allergies that are severe and can be life threatening YES: My child has allergies that ARE severe and can be life threatening EPIPEN: My child has an allergy that requires the use of an EpiPen

Please list any allergies your child has to food, medicine, or the environment. Please include food sensitivities. Write "None" if this is not applicable.

Are there any other special needs you would like our teachers/leaders to know- we will contact you.

Yes No

Additional Information

Just a few more odds and ends:

Photo Release * From time to time, photographs of children are taken during church school and worship activities. These photos are used to promote programs and events and are at times used on CCC bulletin boards or the website. It is CCC policy to not include children’s names on photographs on the CCC website. CCC is requesting your permission and consent to use photographs of your child(ren) alone or in group settings, in CCC materials. * Please indicate your choice from the options below, indicating consent.

YES, I am the child's parent or legal guardian and I GIVE PERMISSION for my child’s/children’s photographs to be in CCC materials. NO, I am the child's parent or legal guardian and I DO NOT want my child’s/children’s photographs to be used in CCC materials.

Would you be willing to be a CCC Church School classroom helper once a month?

Yes No

Is your student (ages 3 through 5th Grade) interested in joining the Children's Music Time which meets before church school? Yes No

For Cooperative Youth Ministry (6-12 Grades), please indicate your home church family: Christ Congregational Church Family Takoma Park Presbyterian Church Family Other

Church School/Youth Programs Covenant

As a community in Christ we build our programs around the promise to be in relationship with one another. We ask our teachers, parents and children to commit to this covenant as part of CCC’s Church School/Youth Group programs. Please read and discuss the covenant with your child.
(We understand that some of our Church School children are too young to fully understand this covenant, but we ask parents and guardians to spend some time explaining the expectations of Church School to your children in a way they can understand, knowing through the year they will continue to learn what it means to be a part of the Church School at CCC.)
Hard copies of the following covenant are available with the Church School Superintendent.

CHURCH SCHOOL COVENANT:
Because God calls us into faithful community in Christ’s church, I covenant with God and others to conduct our life together at Christ Congregational Church in a manner that promotes positive, respectful, affirming, healthy and safe relationships.

AS A STUDENT in Church School/Youth Programs . . .
• I will participate in activities, working together to learn and grow from my Church School/Youth Program experience.
• I will be open to new ideas and experiences and to trying new things.
• I will welcome new students and treat all people with dignity and respect.
• I will listen when other people are talking.
• I will respect the personal space and property of others.
• I will use the classroom, toys and supplies made available to us with care. If I accidentally damage any property, I will take responsibility for the damage done and inform my teacher/leader right away.
• I will wait in my classroom when Church School ends until my parent or guardian meets me.

As PARENT OR GUARDIAN of a Church Schooler/Youth Grouper…
• I will encourage my child to participate in Church School/Youth Group, learning and growing in God and community by bringing them to church.
• I will work to arrive on time to worship, so that they can fully participate in the worship and the entirety of the classroom program.
• I will encourage my child by asking about the activities and projects from their classes.
• I will maintain an open line of communication with my child's teachers/leaders and the Church School Superintendent/Youth Program Director to provide feedback about problems and successes.
• I will support the Church School program/Youth Group by volunteering my time to teach, provide supplies or snacks, participate in classroom preparation prior to each unit, shepherd during communion worship and/or offer feedback to the Coordinating Council and Staff about the programs.
• I will meet my child in their classroom promptly after worship and Church School.

As a CHURCH SCHOOL TEACHER/YOUTH LEADER…
• I will strive to create a welcoming and inclusive environment where all children are comfortable.
• I will strive to learn all the children’s names and greet them by name.
• I will come to church on Sunday with a lesson and activity prepared from our Seasons of the Spirit curriculum to engage children in growing in their faith.
• If there is problem or concern about a child’s behavior or well being, the curriculum or other part of Church School, I will contact the parent and/or the Church School Superintendent and work together with her to create a positive resolution to the challenges.
• I will work with my teaching team to forward weekly communications to my class parents keeping everyone informed and engaged.

Together, this is what we covenant.

I, as parent/guardian of the registering student, agree to this covenant and

have discussed the stated covenant with the student. will discuss the stated covenant with the student before church school begins. am not the parent/guardian, but will share the stated covenant with the student's parent/guardian.

2017/18 CCC Church School/Youth Programs Registration Form

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