This generation is a weekly group of kids from Palmyra Middle and High School that meet at New Covenant Church for a Bible lesson. We take them from the schools for one hour every week and go over scriptures, pray with them, and teach them how to apply the Word of God to their everyday lives. It is available to all students at Palmyra Middle and High School.

Name *

First Name

Last Name

Email *

I give my child permission to attend the This Generation program at New Covenant Church of Palmyra located at 695 E. Ridge Rd. Palmyra, PA. Please Choose ONE:

Yes, My child may attend the HIGH SCHOOL program

Yes, Yes, My child may attend the MIDDLE SCHOOL program

Students grade level: Please choose ONE

6th

7th

8th

9th

10th

11th

12th

Parent/Guardian name (First and Last) *

Parent/Guardian Email *

Parent/Guardian Phone Number *

Emergency Contact Name and Phone Number (in the event parent/guardian cannot be reached):

Student Allergies including food and any special needs

I give permission for This Generation to use photos/videos of my student in print or electronic medias for publicity purposes. *

Yes

Transportation will be provided by NCC for students attending the Palmyra Middle School and High School. I give permission for my child to be transported by NCC and understand that seat belts must be worn at all times. *

Yes

I understand that NCC does not provide transportation for Homeschool/Cyber school students. Transportation is the sole responsibility of parent/guardian. *

Yes

Homeschooler/ Cyber School Students will ONLY be released to the parent/guardian(s) listed on this form. Please list the name and phone number of ONE additional guardian you authorize to pick up your student.

In the event of an emergency, I understand that every effort will be made to contact me. I consent to any deemed necessary medical examinations and treatment until I can be reached. I agree to pay all costs and expenses incurred in connection with those services. *

Yes

I do release, acquit, and forever discharge and covenant to hold harmless and indemnify NCC, This Generation, and their respective representatives, pastors, employees and volunteers from any and all liability, claims or damages arising out of any accidents , sickness, or treatment thereof incurred by said student during participation in This Generation. *

Yes

I have read the above information and give my consent. I understand that by typing my name below, it will act the same as my written signature. Parent/Guardian Signature Please include Date. *

Thank you for registering your child(ren) for This Generation. You will be receiving a confirmation email soon with further details. If you have any questions, please call the Church Office at 717.838.2033 or email lisavcf@gmail.com or Pastor Nadine rhoads7lynette@gmail.com

Thank you!

Bible Advendture

Bible Adventure is a program in partnership with Joyel Ministries. Through this program we host students in Forge and Northside elementary schools at our church for one hour every week. During this time they learn Bible stories, they are assigned seasons believers to guide them through the Bible, and they build a community of students that love Jesus!

newcovenantpalmyra@gmail.com
(717) 838-2033

695 E. Ridge Rd. Palmyra, PA 17078

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