Registration Form

Elevated Youth Registration

Summer 2026 · Elevated Youth

Complete Your Application

Complete the form below to secure your child’s enrollment

📌 Important: Please complete all required fields marked with ★. After submitting, you will receive confirmation and be redirected to complete the non-refundable $75 registration fee payment to secure your child’s spot.

Parent Information

Parent Full Name

Email Address

Phone Number

Alternate / Emergency Phone

Relationship to Child

Are you a church member?

Home Address

How did you hear about us?

Student Details

Child Full Name

Date of Birth

Child Age

Gender

Program Session

Age Group

Choose Enrollment Plan

T-Shirt Size

Health & Safety

Emergency Contact Name

Emergency Phone

Known Allergies (food, medication, environmental)

Current Medications (name & dosage)

Physician / Doctor Name

Physician Phone Number

Child's Insurance Provider

Insurance Policy Number

Medical Notes / Allergies

📜 Program Agreements

Payment Policy Agreement

By submitting this form, you acknowledge and agree to the following payment terms for the Elevated Youth Summer Program 2026:

Registration fee of $75 per child is due immediately and is non-refundable.
Weekly tuition is due every Monday by 9:00 AM. A $10 late fee applies after the deadline.
Session tuition is paid in full on the first day of each session.
Tuition is not prorated for absences, vacations, or early withdrawals.
Multi-child discount of $10/week or $50/session per additional child will be applied at checkout.
All payments must be made online. No cash accepted.

Program Agreements

I have read and agree to the Payment Policy. I understand the registration fee is non-refundable and all fees are due by the stated deadlines. I authorize The River of God Evangelistic Church staff to seek emergency medical treatment for my child if I cannot be reached. I agree to the program's Code of Conduct. I understand that children are expected to show respect to staff and fellow participants at all times. I give permission for my child's photo/video to be taken for church and program use, including social media and promotional materials. (Optional)

Become A Donor

Contact Info