Youth Registration 2025-2026

Information received is confidential and is being gathered for the purposes of serving your Youth while in the care of Unionville Alliance Church. Any medical information collected here serves to authorize Unionville Alliance Church, and its staff and volunteers, to obtain medical assistance in emergencies. In the case of custody agreements, please include the proper form authorizing Parental contacts.

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

Your name *

Email address *

Household members

Address

Medical Consent/Release *

I/we, the Parents or guardians named below, authorize Unionville Alliance Church Ministry Personnel to sign a consent for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for the participant named above, if I/we are unavailable. I/we, named below, undertake and agree to indemnify and hold harmless Ministry Personnel, Unionville Alliance Church, and its Leaders from and against any loss, damage or injury suffered by the participant as a result of being part of the activities of Unionville Alliance Church, as well as of any medical treatment authorized by the supervising individuals representing Unionville Alliance Church. This consent and authorization is effective only when participating in or traveling to events sponsored by Unionville Alliance Church.

Photo Release *

I give Unionville Alliance Church permission to use photographs, video or electronic images of my Child(ren)/Youth. I authorize Unionville Alliance Church to copyright, use and publish the media for any lawful purpose to highlight or promote Unionville Alliance Church. By checking this box and signing I indicate that I have read and understood the above release.

Would you like to receive youth ministry email updates?

Final Notes

Upon completion of this form, you will receive an email request to complete the "Signature of Release" form. Please sign this form on Jotform to complete your child's registration.

Questions? Contact JustinH@uachome.org.