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).

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!

Payment: please bring or mail a 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 scholarship or interested in offering a scholarship to another child, please email Kayla Belcher at olivetbible@gmail.com.

Primary Parent/Guardian

First Name *

Last Name *

Phone *

Email *

Secondary Parent/Guardian

First Name

Last Name

Phone

Address

Street Address *

Address Line 2

City *

State *

Zip Code *

Country *

Alternate pick-up / emergency contacts (name, relationship, phone) *

Child 1

First Name *

Last Name *

Birthday *

Age as of September 10th *

Medical or allergy information *

Child 2 (optional)

First Name

Last Name

Birthday

Age as of September 10th

Medical or allergy information

Child 3 (optional)

First Name

Last Name

Birthday

Age as of September 10th

Medical or allergy information

Child 4 (optional)

First Name

Last Name

Birthday

Age as of September 10th

Medical or allergy information

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 at 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 *

* If you are registering more than 4 children, please submit another form.