Adventurer Club Membership Application

X/Twitter

This field is for validation purposes and should be left unchanged.

Name*

First Last

Date of Birth*

Grade*

Parent/Guardian Name*

First Last

Mailing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Phone*

Country Phone Number

Cell Phone*

Country Phone Number

Parent/Guardian Email*

Church*

School*

Check level(s) the child has completed:*

Little Lamb

Busy Bee

Eager Beaver

Sunbeam

Builder

Helping Hand

Child T-shirt Size

Youth Small

Youth Medium

Youth Large

Adult Small

Adult Medium

Adult Large

Pledge

Because Jesus loves me, I will always do my best.

Law

Jesus can help me to: Be obedient, Be pure, Be true, Be kind, Be respectful, Be attentive, Be helpful, Be cheerful, Be thoughtful, Be reverent.

I want to join the Norridgewock SDA Church Adventurer Club

Yes

Applicant Commitment

I will attend meetings, activities, field trips, and other club activities. I will proudly wear my Adventurer uniform and obey club guidelines. I will be cheerful, helpful, honest, kind, and courteous.

Yes/No

Yes

Electronic Signature*

First Last

Parent/Guardian Commitment

As parent/guardian, I understand that the Adventurer Club is active and includes many opportunities for service, adventure, fun, and learning. I will support the program by: 1. Encouraging my Adventurer to take an active part in all club meetings and functions. 2. Attending events in support of my Adventurer. 3. Assisting club leaders by serving as a helper when needed. 4. Not holding any individual club staff member liable in the event of an accidental injury. 5. Giving my permission for the above named Adventurer to attend Adventurer activities.

Yes/No

Yes

Electronic Signature of Parent/Guardian*

First Last

Date*