InTune

Children's Ministry Application

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Medical Information
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** If yes, please complete the following medical information **
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Please check areas where your child will be involved this year
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Waiver
By submitting this form you ensure the accuracy of the information submitted and agree to allow this information to be shared with the appropriate administrators.
By submitting this form I give permission for my above mentioned dependent to participate in the activities of InTune Children's Ministries of Pickering Pentecostal Church. In the case of a medical emergency, I understand that an attempt to contact myself will be done immediately. If I cannot be reached and immediate attention is required, I grant permission for the Children's Ministries staff to act in the best interest of my child.
As a parent of the above-mentioned student, I also grant permission to use my young person's name, photograph, and/or likeness in connection with any InTune/Pickering Pentecostal Church events such as brochures, promotional materials, church bulletins, website, and newsletters.
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Pickering Pentecostal Church is collecting and retaining this personal information for the purposes of enrolling your child into our programs, to assign your child to the age appropriate class, to develop and nurture ongoing mentoring relationships for you and your child. This information is retained indefinitely as required by our insurance company and legal counsel. This information is only used within Pickering Pentecostal Church. If you wish Pickering Pentecostal Church to limit the information collected or to view your child's information, please contact us.
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