Royal Ranger Registration Form Royal Rangers – Boy Registration Form Parent/Guardian Information Parent/Guardian Name * Parent/Guardian Name First Name First Name Last Name Last Name Email Address * Phone Number * Address * Address Address Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Church *Please update if you are joining us from a different church Boy(s) Information Press the +Add button below to add additional boys Name * Name First Name First Name Last Name Last Name Date of Birth * Age Current School Grade Level * 0-Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade 9th Grade (Freshman) 10th Grade (Sophomore) 11th Grade (Junior) 12th Grade (Senior) Group Email Address Phone Number Known Allergies, Illness, etc. plus1 Add minus1 Remove Emergency Contact #1 Name * Name First Name First Name Last Name Last Name Phone * Relationship to Child * MotherFatherStepmotherStepfatherGrandmotherGrandfatherBrotherSisterAuntUncleFoster parentAdoptive parentOther Relationship to Child Emergency Contact #2 Name * Name First Name First Name Last Name Last Name Phone * Relationship to Child * MotherFatherStepmotherStepfatherGrandmotherGrandfatherBrotherSisterAuntUncleFoster parentAdoptive parentOther Relationship to Child Consent Form Consent to Contact Minor Child(ren) I, hereby authorize Calvary International Church to contact my minor child(ren) listed in the above form, using the information provided above for the purpose of providing updates, discussing ranger events, conducting follow-ups, etc. If a child is contacted the parent/guardian will be included in all communications. Consent to Contact Minor Child(ren) * I consent and agree to the terms and conditions. I do not consent, and would like all notifications to be sent directly to myself. Media Release Consent I hereby grant Calvary International Church permission to capture, record, and use my (or my child’s) image, voice, and likeness in photographs, videos, or other media taken during events, activities, or programs. I understand that these materials may be used for promotional, educational, or informational purposes, including but not limited to social media, websites, printed materials, and other media platforms. I acknowledge that Calvary International Church owns the rights to these materials and that I will not receive compensation for their use. I also understand that I may withdraw consent at any time by providing written notice to rangers@cicbrooklyn.com. Child(ren) Media Release Consent * I consent and agree to the terms and conditions. Acknowledgment of Risk & Release of Liability I, the undersigned parent/guardian, acknowledge that my child’s participation in any event, activity, or program organized by Calvary International Church—whether scheduled now or in the future—may involve physical activity and other inherent risks, including but not limited to injury, illness, or other harm. I understand that these risks exist for all activities associated with Calvary International Church. I certify that my child is physically fit to participate and has no medical conditions that would prevent safe engagement in any event or activity. In consideration of my child being allowed to participate, I agree to release, waive, and hold harmless Calvary International Church, its officers, employees, volunteers, affiliates, and event sponsors from any and all claims, liabilities, demands, or causes of action arising out of or related to my child’s participation in any event or activity, including injury, illness, death, or property damage, whether caused by negligence or otherwise. Acknowledgment of Risk & Release of Liability Child(ren) * I consent and agree to the terms and conditions. Signature * signature keyboard Clear Submit If you are human, leave this field blank.
