theStone Students: 2025-2026 Registration

Section 1: Parent information

Choose one:

First-Time Registering Re-Registering Just Visiting

Parent/Guardian First and Last Name:

Primary Address:

Cell Phone Number:

Primary Email:

This address will receive a confirmation email

Additional Emergency Contact Name and Phone Number:

I can serve in theStone Student Ministry (choose one): Weekly Bi-Monthly Monthly Other

Consent

By registering my child(ren) for theStone Student Ministry, I acknowledge and authorize my child(ren) may be photographed and/or filmed for use in print, video, and/or web presentations on behalf of theStone Church.

Agree Disagree

Do you wish to receive Text Messages?

Yes No

By selecting "Yes" above, I am consenting to receive SMS messages from Breeze regarding information and announcements for theStone Church . I understand that message and data rates may apply and message frequency varies. I can opt out by responding STOP at any time. For support I can text HELP to 87447. Please review the Breeze Privacy Policy and Terms of Service available at breezechms.com for more details.

Liability Waiver/Release Form: I acknowledge that my child may participate in various youth ministry events sponsored by theStone Church from August 2025 through August 2026, including but not limited to: Participation in games (indoor and outdoor),Bonfires, Short road trips in the church van, Events where food is served. I understand that participation in youth group activities involves inherent risks, including physical activity, travel, outdoor events, and consumption of food. I hereby give permission for my child to participate in all official youth events organized by theStone Church during the school year and acknowledge that I voluntarily assume all risks associated with these activities. In the event of an emergency, I authorize theStone Church staff or designated adult leaders to secure medical care for my child as deemed necessary, including transportation and treatment. I understand that every effort will be made to contact me prior to such action. In consideration of my child’s participation in these events, I, on behalf of myself, my child, and our heirs, assigns, and personal representatives, hereby release, waive, discharge, and hold harmless theStone Church, its pastors, staff, volunteers, and representatives from any and all liability, claims, demands, or causes of action for injury, illness, death, or property damage arising from or related to participation in youth events, including transportation and food consumption. Consent: I have read and understood this waiver. I certify that I am the parent or legal guardian of the participant and have full authority for this document.

Agree Disagree

Child #1 information

Child's Name (First and Last)

Nickname (if applicable)

Birthdate

Gender

Male Female

Allergies/ Special Concerns

Grade

5th 6th 7th 8th 9th 10th 11th 12th

Name of School

Child #2 information

Please complete each question from child #1 for each additional child.

Child's Name (First and Last)

Nickname (if applicable)

Birthdate

Gender Male Female

Allergies/ Special Concerns

Grade 5th 6th 7th 8th 9th 10th 11th 12th

Name of School

Child #3 information

Child's Name (First and Last)

Nickname (if applicable)

Birthdate

Gender Male Female

Allergies/ Special Concerns

Grade 5th 6th 7th 8th 9th 10th 11th 12th

Name of School

Child #4 information

Child's Name (First and Last)

Nickname (if applicable)

Birthdate

Gender Male Female

Allergies/ Special Concerns

Grade 5th 6th 7th 8th 9th 10th 11th 12th

Name of School

theStone Students: 2025-2026 Registration

Description

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