Freedom Youth (6th-12th gr.) Registration

Please add primary parent/guardian information

Your name *

Email address *

Phone number *

Address *

Relationship to student(s) *

Emergency Contact (different than primary guardian information) *

Emergency Contact Phone Number *

Prohibited persons

Please indicate any person(s) that are prohibited from picking up your student(s) from Freedom programming.

Student(s) Information

Please add 6th-12th grade household family members you are registering for Freedom programming using the "Add Child" button below.

Household members

Address *

Special Services *

Do any of your students require any special education services (IEP, 504 Plans, etc.) provided?

Additional Information

If there is any additional information that would be helpful for our staff to know regarding your student (e.g., “my child is sensitive to…” or “my student struggles with…”), please enter it here. If applicable, include your child’s name and clearly describe the specific need for each child you are referencing.

Program Session *

Please register my student(s) for the following session(s):

Fall (September - December)

Spring (January - May)

Summer (June - August)

Parent/Guardian Persmissions

Please review the following and indicate your consent:

I grant permission for my child to participate in all program activities provided by Freedom for Youth Ministries, including those involving supervised instruction, mentorship, and hands-on experiences. I acknowledge that these activities will be conducted under appropriate adult supervision. I also authorize Freedom for Youth Ministries to provide basic care as needed during participation.

I understand that participation may involve inherent risks, and by granting permission, I voluntarily assume those risks on behalf of my child(ren). I hereby release and hold harmless Freedom for Youth Ministries, its staff, volunteers, and partners from any liability or responsibility related to my child(ren)'s participation in program activities.

Parent/Guardian Consent Acknowledgement *

By checking this box, I acknowledge that I am granting permission for my child to participate in the activities listed above under adult supervision, and I release Freedom for Youth Ministries from any liability or responsibility related to participation.

Yes, I give permission and agree to the terms stated above.

Field Trip Permission *

I give my student(s) permission to take my student(s) on field trips off campus.

Yes

Van Transportation Permission *

I give Freedom permission to pick up and take home my student(s) in Freedom vehicles.

Yes

Photography Release *

I give Freedom permission to photograph or video my student(s) while at Freedom programming for use in promoting Freedom for Youth Ministries in advertising, print, social media and other channels.

Yes

Commitment Statement *

I am committed to my student(s) attending Freedom consistently, and understand that if he/she misses more than three weeks, their spot may be given to a student on the waitlist.

Yes

I am ready to register! *

YES!

A copy of your responses will be sent to your email address.