GEMS Registration

Release Form:

By completing the GEMS Registration Form, you are the parent/guardian of the named child and have given consent for her to attend GEMS at The Junction Church St. Thomas for the GEMS season 2023-2024. You hereby release The Junction Church Volunteers from any and all liability for any injury, loss, or damage to person or property that may occur during the GEMS season. In the event of an emergency, you hereby authorize a volunteer of this event to consent to medical treatment as deemed necessary.

GEMS girls club requires girls to be properly dropped off and picked up in their FULL UNIFORM, except for craft days, and if notified.

*Denotes Required Field * Title

* First Name

* Last Name

* Email

* Phone () –

* Address 1

Address 2

* City

State/Prov

* Zip/Postal Code

* GEMS First/Last Name

* Birth Date (mmm/dd/yyyy)

* Grade Level

* Allergies or Other Medical Conditions

* Emergency Contact Name

* Relationship

* Phone

* Does your daughter require transportation?

* Are you able to provide transportation for GEMS who require a ride?

* Hobbies/Interests

* Do you give media consent for Pictures, Videos, GEMS Facebook and or The Junction Website?