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Pioneer Club Registration
We're excited to welcome your child to Pioneer Club! Click below to complete our registration form. It only takes a few minutes and helps us provide a safe, fun, and meaningful experience for every child.
Parent/Guardian
Relationship to Child
Please Choose
Mother
Father
Grandmother
Grandfather
Guardian
Foster Parent
Other
First Name
Last Name
Relationship
Mobile Phone
Email
If applicable, please provide information for a second parent or guardian. This helps us keep our church records up to date and communicate with your family.
Home Address
Address
Apartment, suite, etc.
City
State
Zip/Postal Code
Phone Number
Volunteer Opportunities
Pioneer Club is made possible by amazing volunteers!
If you're interested in serving this year, we'd love to connect with you. Whether you can help every week, once a month, or just occasionally, every helping hand makes a difference. Let us know if you'd like to learn more, and a member of our Pioneer Club team will reach out with additional information.
Would you be interested in serving with Pioneer Club this year?
Yes
No
Thank you for your interest in serving with Pioneer Club! We are always grateful for volunteers who are willing to invest in the lives of our children. Please let us know your availability below. Whether you can help weekly, occasionally, or with special events, we'd love to connect with you. A member of our Children's Ministry team will follow up with additional information and any required volunteer forms.
What is your general availability?
Every Wednesday
Most Wednesdays
About once a month
Occasionally, when needed
I'm not sure yet, but I'd like more information
Child's Information
Child's First Name
Child's Last Name
Does your child attend Gravel Hill Childcare (GHCCC)
Yes
No
Use to
Birthdate
Month
January
February
March
April
May
June
July
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October
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December
Date
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Age
Grade
Pre-K
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Allergies
Emergency Contacts & Authorized Pickups
Who will be picking up your child each night?
Only if different from the parents/guardians.
Emergency Contact First Name
Emergency Contact Last Name
Emergency Contact Phone Number
Photo & Media Release
I understand that children participating in Pioneer Club may be photographed or recorded during club meetings and activities, and that these images or recordings may be used by Gravel Hill UMC of Palmyra for informational, promotional, or ministry-related purposes.
Liability Release
I understand that while the leaders and volunteers of Pioneer Club at Gravel Hill UMC of Palmyra will take every reasonable precaution to ensure my child's safety, accidents can occur. In the event of an emergency, I authorize the leaders or designated staff of Pioneer Club to obtain necessary medical treatment for my child. I understand that every reasonable effort will be made to contact me or my emergency contact as soon as possible. If I cannot be reached, I authorize emergency medical care, including treatment deemed necessary by licensed medical personnel. I further agree that Gravel Hill UMC of Palmyra and its staff and volunteers shall not be held liable for injuries or accidents that may occur in connection with Pioneer Club activities, except as otherwise provided by law.
Pioneer Club Parent Acknowledgement & Behavior Agreement
Thank you for entrusting your child to Pioneer Club at Gravel Hill United Methodist Church. Our goal is to provide a safe, welcoming, and Christ-centered environment where every child can learn, grow in their faith, build friendships, and have fun.
To help create a positive experience for everyone, we ask that each child:
Treat others with kindness, respect, and compassion.
Listen to and follow the directions of Pioneer Club leaders and volunteers.
Use respectful language and appropriate behavior.
Keep their hands, feet, and objects to themselves.
Respect church property, supplies, and the belongings of others.
Participate in activities in a way that allows everyone to learn and enjoy the evening safely.
Behavior Expectations
Our leaders are committed to responding to behavioral concerns with patience, grace, and consistency. If a child chooses not to follow these expectations, the following steps may be taken:
A private verbal reminder and redirection.
Removal from the activity to sit with a leader.
Parent or guardian notification.
If behavior continues or poses a safety concern, a parent or guardian may be asked to pick up their child before Pioneer Club concludes.
For the safety and well-being of everyone, behaviors including—but not limited to—physical aggression, bullying, threatening language, intentional destruction of property, repeated disruption, or actions that place the child or others at risk will not be permitted and may result in immediate parent contact and removal from the program.
Our desire is not to punish children, but to help them grow in Christ-like character while maintaining a safe, respectful, and welcoming environment for every participant.
Parent Acknowledgement & Signature
By signing below, I acknowledge that I have read and understand the Pioneer Club Parent Acknowledgement & Behavior Agreement, Medical Authorization, and Photo & Media Release. I have reviewed the behavior expectations with my child and understand that Gravel Hill United Methodist Church is committed to providing a safe, Christ-centered environment for all participants. I understand that I may be contacted if behavioral or medical concerns arise during Pioneer Club.
Signature
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