2021-2022 Hayes Elementary School Student Registration

Thank you for the opportunity to minister to your child! Please fill out the form completely, then select Submit. You will receive an email with all pertinent club information.

By signing below, I agree to the following:


· My child, named below, is allowed to attend Ignite 316.


· I understand it is my responsibility to have my child picked up at the end of Club.


· I understand that no Ignite 316 volunteer may provide transportation for my child without prior, written approval

· I understand and agree to the COVID-19 waiver below and understand further information is available at: https://www.ignite316.com/covid-19-info

At Ignite 316 clubs, we will do everything we can to be compliant with all regulations and ensure your/your child’s safety. We have put in place measures to reduce the spread, but cannot guarantee that you/your child will not become infected with COVID-19.


 


COVID-19 Waiver: With full knowledge of the risks involved, I hereby release, waive, discharge Ignite 316, its board, officers, independent contractors, affiliates, employees, representatives, successors, and assigns from any and all liabilities, claims, demands, actions, and causes of action whatsoever,  directly or indirectly arising out of or related to any loss, damage, injury, or death, that may be sustained by me/my child related to COVID-19 while participating in any activity while in, on, or around the premises or while using the facilities that may lead to unintentional exposure or harm due to COVID-19.

By signing via electronic signature method you are agreeing the electronic signature will be given full legal effect under federal and state law as if it were hand written. You are agreeing that you have read and understand the statements listed above.
 
Child's Information

Please enter only one child per form.
Use Child's LEGAL Name, then add Nickname below, where applicable. 
*Nickname should be what your child wants to be called in club.
 
 
 
 
 
Please select one option.
Please select one option.
Contact Information

Please enter the BEST Phone Number and Email Address 
for correspondence with your child's Ignite 316 Team Leader.
 
 
 
 
 
 
Emergency Contacts

Please list IN ORDER those we will need to call in case of emergency.
Parents will always be called first.
 
 
 
 
 
 
Special Instructions

Please select one option.
 
 
 
 
Please select one option.
 
 
 
 
Please select one option.
 
 
 
 
 
 
 
 
Pickup Information

 
 
 
 
Other

Please select one option.
 
OPTIONAL Photography and Video Release

Ignite 316 may, from time to time, document the activities of the ministry with photos or videos. By signing below, you agree to assign and grant to Ignite 316, its subsidiaries and successors, and assign the unqualified right to the ownership, use and proceeds of all photographs or video of me or my minor child, without reservation or limitation, including use of photographs or video of me or my minor child for, but not limited to, advertising, educational and promotional purposes.
Please select one option.
By signing via electronic signature method you are agreeing the electronic signature will be given full legal effect under federal and state law as if it were hand written. You are agreeing that you have read and understand the Photography and Video Release statement listed above.
 

Description

Thank you for the opportunity to minister to your child! Please fill out the form completely, then select Submit. You will receive an email with all pertinent club information.