Caring, Praying, Responding
Peterborough Free Methodist Church

Circle of Friends Registration Form

Peterborough Free Methodist Church – 2021-2022

Please fill out the online form below; please indicate N/A in areas that do not apply.  OR download this document fill it out and bring it to the church. 

 Circle of Friends Registration Form

(One form per student to be completed for anyone under the age of 18)

Information received is confidential and is being gathered for the purposes of serving your child while in the care of the Peterborough Free Methodist Church.  Any medical information collected here serves to authorize the Peterborough Free Methodist Church, and its staff and volunteers to obtain medical assistance in emergencies.

Biographical Data
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Please select one of the following:
Family Data
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Emergency Contact Information
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Secondary Address of Student (If Student resides at least partially with another parent or guardian)
Medical Information
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Medical Condition/Special Needs*
Photos/Videos
Occasionally pictures and video are taken to capture memories of certain events and to share with the rest of the congregation. Pictures and videos may be used for the purpose of promotional material on the church website and Facebook page, or in our worship services that are live streamed on Youtube. Please indicate your permission below:*
Custody Orders or Issues
I, named below, undertake and agree to indemnify and hold blameless Peterborough Free Methodist Church, its personnel, its Directors and Board from and against any loss, damage or injury suffered by the participant as a result of being part of the activities of the Peterborough Free Methodist Church, as well as of any medical treatment authorized by the supervising individuals representing the church. I have read, understood and agree with the above.*
I/we, the parents or guardians named above, authorize Holly Raymond or her designate to sign a consent for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for the participant named above in the event of an emergency. While every precaution will be taken to ensure the safety and protection of your child, Peterborough Free Methodist Church, its pastors, representatives and Board of Elders are hereby released from any and all liability in the event of loss, damage, or injury suffered by the participant as a result of being part of the activities of the Peterborough Free Methodist Church. *
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Validation Code