School Year Program Registration

Please fill out this form and click submit.
Hi Parents, whether you are signing up your child to Solid Rock for the first time or the 100th time we are having everyone fill out the complete form. We are asking you to do this for our sake because as children grow and change so do circumstances and phone numbers and addresses. We want to be up-to-date on all information so that we can serve you and your child to the best of our abilities. We apologize for any incovenience this may cause you.
All Solid Rock school programs are completely FREE! The programs are for the grade that the student is entering or enrolled in. All are invited to come to as many of the programs as they would like!


All of our programs require an attendance commitment in order for the programs to run properly. If you would like to participate in a program, but have attendance concerns, discuss them with the Program Director. We want everyone to be able to attend our programs!


You can find descriptions of all our school programs here. If you have any questions or would like any more information, contact the Program Director at (717) 803-0355 or solidrockprogramdirector@gmail.com.


If you would like a paper registration form, let us know and we will mail one to you for free or email a digital version to you.
Student Information

 
 
Please select one option.
 
 
Please select one option.
Please select one option.
Please select one option.
Please select all that apply.
Medical

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Parent, Guardians and Emergency Contacts

 
 
 
 
 
 
 
 
Program Selection

Students are welcome to attend as many programs as they can.
Please select all that apply.
Permissions

Attendance and Transportation Terms:
By checking the box below, I give my permission for my child to attend Solid Rock Youth Ministries' programs, events, and activities, to ride in vehicles driven by Solid Rock staff or volunteers, and to walk to the park for some activities. I will pick my child up promptly at the time the program is over.
Please select all that apply.
Additional Pickup Permissions:
Parents or guardians and the emergency contact listed earlier in the form will be allowed to pick up students from Solid Rock programs and events. Please list below any additional individuals we should allow to pick up your child.

If someone who is not on this list attempts to pick up your student, including your other children, we will call you before allowing them to pick up your student. Please note if anyone is legally restricted from seeing your child.

 
 
 
 
Liability Waiver & Emergency Treatment Consent:
By checking the box below, I give Solid Rock Youth Ministries permission to seek whatever medical attention is deemed necessary, and release Solid Rock and its staff of any liability against personal losses. I/We the undersigned have legal custody of the student named above, a minor, and have given our consent for him/her to attend events being organized by the youth center. I/We hereby release the youth center, its directors, employees, agents, and volunteer workers from any and all liability for any injury, loss, or damage to person or property that may occur during the course of my/our child’s involvement. In the event that he/she is injured and requires the attention of a doctor, I/we consent to any reasonable medical treatment as deemed necessary by a licensed physician. In the event treatment is required from a physician and/or hospital personnel designated by the youth center, I/we agree to hold such person free and harmless of any claims, demands, or suits for damages arising from the giving of such consent. I/we also acknowledge that we will be ultimately responsible for the cost of any medical care should the cost of that medical care not be reimbursed by the health insurance provider. I/we also agree to bring my/our child home at my/our own expense should they become ill or if deemed necessary by the student ministries staff member.
Please select all that apply.
Media Permission:
Solid Rock occasionally takes pictures to inform the community what we are doing through Facebook, Instagram, our website, the newspaper, etc. You may opt out of this if you would prefer.

If you would like to give Solid Rock permission to use pictures and/or videos of your child in publications, news releases, online, and in other communications related to the mission of Solid Rock Youth Ministries, click "Yes" below.

Please select one option.
Walking Home / Leaving without Signout:
Students in 5th grade or above may walk home from Solid Rock programs and events if given permission from a parent or guardian. This is intended to be a convenience for parents who live near Solid Rock with older children capable of safely crossing streets and responsibly walking home. 

*Note: A parent may also want to give this permission if they would like their child to be able to leave Solid Rock without having to enter the building to sign the child out (even if they are not walking home). For example, some parents would like to be able to text their child when they arrive and let them know to come out to their car. We will allow this if you give this permission.

Please select one option.
 

Description

Please fill out this form and click submit.