REGISTRATION

How many children are you registering ?

Child's Information

Name

Age

Grade:

School:

Does this child have any allergies or physical limitations that the staff should be aware of?

#2 Child's Information

Name

Age

Grade:

School:

Does this child have any allergies or physical limitations that the staff should be aware of?

#3 Child's Information

Name

Age

Grade

School

Does this child have any allergies or physical limitations that the staff should be aware of?

Parent/Guardian Information

Name:

Cell Phone Number

Yes, it's okay to send me text messages including confirmations, changes, updates, and/or promotions. Message frequency varies. Message and data rates may apply. View our terms of service & privacy policy.

Work Phone Number

Address

If you cannot be reached, who should be notified IN CASE OF EMERGENCY?

Name

Phone Number

Alternative Phone Number

Additional Individuals Approved to Pick Up

Name

Phone Number

Relationship to Child

Name

Phone Number

Relationship to Child

Annual Registration Fee

2025 Fee ($5 per child) ($5.00)
2025 Fee ($5 per child) ($10.00)
2025 Fee ($5 per child) ($15.00)
Please contact me to pay in cash or by check ($0.00)
If the registration fee presents a financial hardship, please select this option to register at no cost. We believe everyone should have the opportunity to participate. ($0.00)

Code of Conduct

As a participant in The Salvation Army Youth Programs, I agree to conduct myself in a way that reflects positively on myself, my parents/guardians, The Salvation Army, and everyone involved. I will honor this
commitment by:

1. Dressing Modestly and Appropriately
- I will wear clothing that is respectful and suitable for all activities.
- I will follow any dress expectations given by The Salvation Army or its representatives.
- Shirts must provide full coverage-no undergarments, midriffs, offensive language, images, or symbols should be visible. Shirts should not be worn off the shoulders.
- Pants, shorts, and skirts must be worn at the waist and cover undergarments.
- Shorts must extend below the palm of the hand; skirts must reach below the fingertips when arms are at the side.
- I understand that modesty honors God and helps prevent distractions or stumbling blocks for others.

2. Respecting Property and Technology
- I am responsible for my own belongings. The Salvation Army is not responsible for lost or stolen items.
- Electronic devices must be put away during all program activities.
- If a device is used during program time, I will be reminded once. Repeated misuse may result in the device being held by staff and returned at the end of the program.

3. Respecting Others
- I will treat all participants, leaders, volunteers, and guests with kindness and cooperation.
- I will respect the rights, privacy, and property of others.
- I will treat the building and any materials used with care and respect.

4. Avoiding Harmful or Inappropriate Items
- I will not bring or use alcohol, drugs (unless prescribed and documented), weapons (real or toy), explosives, flammables, poisons, or pets.

5. Following Rules and Laws
- I will cooperate with all instructions given by staff, volunteers, and Salvation Army representatives.
- I will follow all local, state, and federal laws.
- I will obey any additional rules set by the program leadership to help ensure a safe and respectful environment.

I have read and understand the Code of Conduct for The Salvation Army Youth Programs. I agree to support
my child in following these expectations.

I, the undersigned, agree to the terms above.

Terms

By signing below, I acknowledge that The Salvation Army, its officers, staff and/or volunteers will not be held responsible for any injury, loss or damage of personal property for the above named individual(s).

If my child will be absent from the program or will be picked up early, I will contact The Salvation Army at least 24 hours before the event/program. I agree to pick up my child at the specified time until other arrangements have been made. I understand that The Salvation Army will not release my child to any individual not listed as a guardian/parent or approved contact.

I give permission to copyright and/or publish images of my child in photographs and/or any media format for the expressed use of The Salvation Army.

I, the undersigned, agree to the terms above.

REGISTRATION

Child's Information

#2 Child's Information

#3 Child's Information

Parent/Guardian Information

If you cannot be reached, who should be notified IN CASE OF EMERGENCY?

Additional Individuals Approved to Pick Up

Billing Information