Children's Program Registration and Consent Form

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Child 1

Invalid Input

Invalid Input

Invalid Input

Invalid Input

/ / Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Child 2

Invalid Input

Invalid Input

Invalid Input

Invalid Input

/ / Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Child 3

Invalid Input

Invalid Input

Invalid Input

Invalid Input

/ / Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Child 4

Invalid Input

Invalid Input

Invalid Input

Invalid Input

/ / Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Purposes and Extent

Russell Alliance Church is collecting and retaining this personal information for the purpose of enrolling your child in our programs, to assign your child to the appropriate classes, to develop and nurture ongoing relationships with you and your child, and to inform you of program updates and upcoming opportunities at Russell Alliance Church. This information will be maintained indefinitely as it is a requirement of our insurance company and legal counsel. If you wish Russell Alliance Church to limit the information collected, or to view your child’s information, please contact us.

Parent/Guardian Options

I have read, understood and agree with the above and sign it to cover all Children’s Program activities for the program year effective as stated above. A separate Informed Letter of Consent will be sent home for off-site activities and activities of elevated risk.

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Our Service Times:
Sunday School:  9:30 am
Worship Service: 10:30 am

Address:
331 Centennial Crescent
Russell, MB R0J 1W0
204-773-3551

© Russell Alliance Church | Webdesign by Bankert Marketing Inc.