SR. High Registration Form Sept 2026- June 2027 • Bethel Pentecostal Church

BETHEL SR. HIGH YOUTH

STUDENT REGISTRATION FORM

Please complete one form for each student. Information is used to help us provide a safe, welcoming, and well-supported youth

ministry environment.

Activity: Bethel Youth

Date: Weekly Sr. High Night at Bethel Pentecostal Church September 2026 - June 2027

Leaders: Annalise and Jefforey Prentice, Nicole Murfin, Pastor Kerby Stivene

Student Information

Parent / Guardian Information

Emergency Contact

Medical / Safety Information

Does the student have any allergies, medical conditions, medications, dietary restrictions, accessibility needs, or other information our youth leaders should know? *

Yes

Please update the youth leadership team if any medical, contact, or emergency information changes during the ministry year.

Pick-Up / Transportation

Transportation for off-site activities or special events may require separate event-specific permission and details.

Participation & Emergency Authorization

I give permission for the student named on this form to participate in regular Bethel Sr. High Youth gatherings and activities held at Bethel Church. I understand that separate permission may be requested for certain off-site events, overnight activities,

In the event of an emergency, I authorize Bethel Sr. High Youth leaders to contact emergency services and to take reasonable steps to obtain necessary medical care for my child if I cannot be reached promptly.

Photo / Video / Media Permission

Bethel Church may occasionally take photos or video during youth gatherings and events for ministry communication, church social media, website, promotional materials, or event recaps. No full student name will be intentionally published with an image without additional permission.

Communication Permission

Youth leaders may communicate with students about ministry schedules, event reminders, group activities, and appropriate pastoral/youth ministry follow-up. Communication may occur through approved ministry channels such as text messaging, group chats, ema

Student expectations

Bethel Sr. High Youth is committed to creating an environment where students can belong, build healthy relationships, ask
questions, grow in faith, and encounter Jesus. Students are expected to:

● Treat other students, leaders, volunteers, church property, and event venues with respect.
● Avoid bullying, harassment, threats, fighting, sexual misconduct, substance use, vaping, or other unsafe behaviour.
● Follow reasonable instructions from youth leaders and respect activity boundaries and safety expectations.
● Use phones and social media responsibly and never photograph, record, or post another student in a way that is humiliating, private, or
unsafe.

Parent / Guardian & signature

By signing below, I confirm that the information provided on this form is accurate to the best of my knowledge. I understand
the permissions selected above and agree to notify Bethel Church of significant changes to the student's emergency, medical,
or contact information.

Privacy Note

Registration information is to be stored securely and accessed only by authorized ministry personnel as needed for youth care and safety.