Events Calendar

Name: Faith Explorers, TEAM & Teen Issues
Start: 2025-09-14T10:00:00-04:00
End: 2025-09-14T11:00:00-04:00

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Faith Explorers, TEAM & Teen Issues

September 14, 2025 @ 10:00 am - 11:00 am

« Sunday Early Morning Worship Service
Board of Christian Service Meeting »

Christian Education Youth Registration Form

"*" indicates required fields

Child 1 - Full Name*

Child 1 - Preferred Name

Child 1 - Age*

Child 1 - Date of Birth*

MM slash DD slash YYYY

Child 1 - Baptism*

Baptized

Not Baptized

Interested in Baptism

Child 1 - Dismissal Code*

Parent/Guardian

Grandparent

Older Sibling

Fellowship Hall (5th Grade and older)

Child 1 - List others who are authorized to pick up child from class.

Child 1 - Grade/Level (if in any type of school)

Child 1 - List ALL allergies to include food, bees, etc. If none, type N/A*

Child 1 - Additional information (medications needed, limitations, etc.)

Child 1 - Cell phone ONLY if in 9th grade & up (parent choice)

Child 1 - Email address ONLY if in 9th grade & up (parent choice)

Do you need to register child 2?*

Yes

CHILD 2 REGISTRATION

Child 2 - Full Name*

Child 2 - Preferred Name

Child 2 - Age*

Child 2 - Date of Birth*

MM slash DD slash YYYY

Child 2 - Baptism*

Baptized

Not Baptized

Interested in Baptism

Child 2 - Dismissal Code*

Parent/Guardian

Grandparent

Older Sibling

Fellowship Hall (5th Grade and older)

Child 2 - List others who are authorized to pick up child from class.

Child 2 - Grade/Level (if in any type of school)

Child 2 - List ALL allergies to include food, bees, etc. If none, type N/A*

Child 2 - Additional information (medications needed, limitations, etc.)

Child 2 - Cell phone ONLY if in 9th grade & up (parent choice)

Child 2 - Email address ONLY if in 9th grade & up (parent choice)

Do you need to register child 3?

Yes

CHILD 3 REGISTRATION

Child 3 - Full Name*

Child 3 - Peferred Name

Child 3 - Age*

Child 3 - Date of Birth*

MM slash DD slash YYYY

Child 3 - Baptism*

Baptized

Not Baptized

Interested in Baptism

Child 3 - Dismissal Code*

Parent/Guardian

Grandparent

Older Sibling

Fellowship Hall (5th Grade and older)

Child 3 - List others who are authorized to pick up child from class.

Child 3 - Grade/Level (if in any type of school)

Child 3 - List ALL allergies to include food, bees, etc. If none, type N/A*

Child 3 - Additional information (medications needed, limitations, etc.)

Child 3 - Cell phone ONLY if in 9th grade & up (parent choice)

Child 3 - Email address ONLY if in 9th grade & up (parent choice)

Do you need to register child 4?*

Yes

CHILD 4 REGISTRATION

Child 4 - Full Name*

Child 4 - Preferred Name*

Child 4 - Age*

Child 4 - Date of Birth*

MM slash DD slash YYYY

Child 4 - Baptism*

Baptized

Not Baptized

Interested in Baptism

Child 4 - Dismissal Code*

Parent/Guardian

Grandparent

Older Sibling

Fellowship Hall (5th Grade and older)

Child 4 - List others who are authorized to pick up child from class.

Child 4 - Grade/Level (if in any type of school)

Child 4 - List ALL allergies to include food, bees, etc. If none, type N/A*

Child 4 - Additional information (medications needed, limitations, etc.)

Child 4 - Cell phone ONLY if in 9th grade & up (parent choice)

Child 4 - Email address ONLY if in 9th grade & up (parent choice)

PARENT/GUARDIAN INFORMATION

Mother/Guardian Full Name

Mother/Guardian Cell Phone Number

Mother/Guardian Email

Mother/Guardian Street Address

Mother/Guardian Town

Father/Guardian Full Name

Father/Guardian Cell Phone Number

Father/Guardian Email

Father/Guardian Street Address

Father/Guardian Town

FAMILY INFORMATION

Which address is the child/youth primary residence?

Family Church Relationship

Members

Friends

Wish to join church

EMERGENCY CONTACT INFORMATION

Emergency Contact Name*

Emergency Contact Phone*

PARENT/GUARDIAN PERMISSION

Nursery and Preschool Parent/Guardian Related Information

Check if applicable

You will need to provide diapers and wipes for your child and a bottle or a cup of juice/water if your child can’t sip through a straw easily. DRCC provides a snack and juice boxes. Our Open-Door Policy encourages parents to drop in and visit whenever they wish.

Safe Conduct Policies and Procedures Volunteers*

Check after reading

All volunteers with children, youth and other vulnerable populations at DRCC must comply with our current Safe Conduct Policies and Procedures, which is available for review in the Director of Christian Education or Church Office.

If you are or become a volunteer, you will receive a copy of the DRCC Safe Conduct Policies and Procedures and be required to sign a form stating that you have received and comply with the policy.

Photography Permission*

Yes, I give permission as noted below

Yes, I give permission as noted below, but face needs to be blurred before publication

No, I don't give permission

Other

I give permission to The First Congregational Church of Deep River to take pictures/video of my child(ren) during Church wide activities, which could be used for church purposes to include but not limited to the Church website, The Messenger, picture disks, social media, power point presentations and the local newspaper. Full names of the child will NOT be published. Parents should be aware the worship service is live-streamed. If you don't want your child to be seen on the live-stream, please speak to our minister or the Director of Christian Education.

Consent*

Consent Agreement

At The First Congregational Church of Deep River, we are a supportive and caring community which comes together to grow in our understanding of and commitment to a Christian life. In that spirit, we agree to support one another in our efforts to abide by our Community Covenant to be: Responsible, Respectful, Prepared, Safe and Kind in all relations and interactions with others - classmates, teachers, staff, congregational members and visitors.

I understand that my child will be asked to reflect upon his/her behavior if it prevents him/her from keeping this promise. When necessary, I know that I may be made aware of my child's need for reflection and made aware of the specifics of his/her behavior. My agreement to support my child's commitment to this Covenant indicates my willingness to discuss appropriate behaviors and choices with my child as needed.

I also understand by entering my name below that both legal parents of the child(ren)/youth noted on form are aware and agree that religious instruction will take place within the classroom. In addition, I also understand that the Community Covenant will be discussed and implemented during all DRCC activities.

Name of person consenting/submitting form*

Relationship to Registered Child(ren)*

Date*

MM slash DD slash YYYY

VOLUNTEER

I can help in the following areas:

Teaching/Team Teaching

Substitute Teaching

Classroom Assistant/Extra Pair of Hands

Nursery

Youth Groups

Confirmation Mentor

Summer Faith Adventures

Baking

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Details

Date: September 14, 2025
Time:
10:00 am - 11:00 am

« Sunday Early Morning Worship Service
Board of Christian Service Meeting »