Westshore Youth Mids Registration

Please Note: You must register before 4pm each Wednesday to save you a spot to and from Youth! If you have any questions, contact Reid Hitchman at reid@coastlinechurch.ca or 778-678-7925 Note: All Coastline Youth Leader have current Criminal Record Checks and will be following our Plan to Protect protocol Meet at our Westshore Ministry House on 766 Meaford Ave. Drop-off time between 5:45-6:00pm. Students and Youth leaders will leave at 6pm to drive to Coastline Victoria Pick up time: 9pm at Westshore Ministry House Please Note: Parent and/or Guardian should fill out this form

Your name *

Email address *

Phone number

How many students will be attending? *

Please list the names (first and last names) of all students attending this week *

Are there any medical concerns or dietary restrictions we should know about? *

(i.e., allergies, injuries, designations)

Emergency contact *

In the case that parent cannot be reached (name and phone #)

Consent Form *

This permission form covers the transportation of the child of the Parent/Guardian(s) named above to Coastline Youth at 845 Caledonia Ave.
Students are to be dropped off at Westshore Ministry House (766 Meaford Ave) between 5:45-6pm and to be picked up at Westshore Ministry House at 9pm. No other person is permitted to pick up the above named student unless organized with Coastline Youth personally. Students will be driven in the vehicles of the pastoral and/or youth leadership team only. No student will ever be alone in a vehicle with a pastoral or youth team member.

While every precaution is taken for the safety and good health of our students, transportation can carry inherent risk. By signing this form, parents understand and accept these risks and agree for their child(ren) to be transported to the event.

Given the information above, please sign your consent below to the transportation of your child(ren) to Coastline Youth.

By checking this form, you are agreeing to the consent form.

Phone number

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