Salt City Registration

Gathering Thursdays from 6-7:30pm September 10th- April 8th!
Registration ($40 per child) is NOW OPEN and includes all supplies for each child for the year!
This year, we'll gather September 10th-December 10th (No Salt City October 1st or November 26th) & January 7th-April 8th (No Salt City March 25th).

Registration Form

We're so glad you're here! Thank you for taking a few minutes to register your child for another exciting year of Salt City. We can't wait to learn about Jesus, hide God's Word in our hearts, build great friendships, and have lots of fun along the way. Please complete the form below so we can get to know your family and prepare for a great year. We look forward to partnering with you as we help your child grow in their faith! Remember, each registered child must be 4 years of age by September 10th and able to use the restroom independently!

* Indicates required field

Primary Parent/Guardian Name *

First

Last

Primary Phone Number *

Email *

Secondary Parent/Guardian Name *

First

Last

Secondary Email *

Secondary Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Please list any Alternate Pick Up Information and/or another other Emergency Contacts you would like us to be aware of. (Name, Relationship to child, Phone Number) *

Child Registration

Child 1 Full Name *

First

Last

Birthday (mm/dd/yyyy) *

Is there any medical or allergy information we should be aware of for your child? *

Age as of September 10th *

Child 2 Full Name *

First

Last

Is there any medical or allergy information we should be aware of for your child? *

Birthday (mm/dd/yyyy) *

Age as of September 10th *

Child 3 Full Name *

First

Last

Birthday (mm/dd/yyyy) *

Is there any medical or allergy information we should be aware of for your child? *

Age as of September 10th *

Child 4 Full Name *

First

Last

Birthday (mm/dd/yyyy) *

Is there any medical or allergy information we should be aware of for your child? *

Age as of September 10th *

LiABILITY, Medical, and Photo Release WAIVER

Your child's safety is important to us. Every Salt City volunteer has completed a background check and has been trained in our child safety policies and procedures before serving with our kids. Every activity in the Olivet Bible Church (OBC) is carefully planned and supervised. However, even with the best planning and precaution, unforeseen events and injuries can occur. By registering in the OBC Salt City Midweek Program, I agree to assume and accept all risks and hazards inherent in Salt City Midweek activities at OBC.

I acknowledge that involvement of my child(ren) in the event may involve risk of property damage and of personal injury, illness or even death, including but not limited to the risks arising from recreational activities, accidents in and around facilities, adverse weather conditions, and injuries and illness as a result of food-borne illnesses and allergic reactions. I waive and release all rights and claims against Olivet Bible Church, including all leaders, staff and volunteers. By signing this Parental Consent and Release of Liability, I state that my child(ren) is fully capable of safely participating in all event activities, and I expressly assume all risks of my child(ren)’s involvement. In case of a medical emergency, I give permission to the hospital/physician selected by those in charge to secure proper treatment for my child(ren) at parent's expense.

I also consent to the public use of any photos and/or video used for minimal use on behalf of Olivet Bible Church. I understand that church events are photographed/recorded for end-of-year videos, occasional social media posts, & website updates. I hereby grant permission to OBC Salt City Midweek to use photos/videos of my child(ren) for these purposes.

Initial Below to Consent *

Make sure to bring or mail check to Olivet Bible Church at 2700 E Henry Street Appleton, Wi 54915 (Memo: Salt City Registration) or bring payment in cash or check by SEPTEMBER 1st!

IF YOU HAVE ANY OTHER QUESTIONS, OR ARE IN NEED OF A SCHOLARSHIPS OR INTERESTED IN OFFERING A SCHOLARSHIP TO ANOTHER CHILD, PLEASE EMAIL KAYLA BELCHER AT [email protected].

Ready to Submit! Let's Go Salt the Earth!

*If you are registering more than 4 children, please fill out and submit another form!

"Walk in wisdom toward outsiders, making the most of the time. Your speech should always be gracious, seasoned with salt, so that you may know how you should answer each person." | Colossians 4:5-6