2025-2027 Rising Tide Student Registration

Welcome to the Crossway Wilmington Rising Tide 4th & 5th Grade Group! We are so excited that your family will be a part of CW Rising Tide!

Please complete the following registration form to help us provide a fun and safe learning environment for our students. For families with multiple children, we've provided a separate, convenient form that you can find by clicking this link. All information will be kept confidential between the Rising Tide Director, Crossway Pastors, and select members of the Rising Tide Servant Team (as needed). Paper copies of registration forms are also available if you do not want your responses stored digitally. If you have any questions, please message Alicia Zander, Rising Tide Director, at risingtide@crosswaywilmington.org.

Rising Tide Policies and Procedures

If you would like to find out more about Rising Tide's policies and procedures for Parents and Volunteers before registering, click here to read our Policies & Procedures Manual.

Student Information

Name

Birthday

Address

Does your child have any allergies/sensitivities to foods or insect bites?

Yes No

Does your child have any allergies/sensitivities to latex or medications?

Yes No

If you answered yes to either of these, please describe so we can let emergency responders know in case of emergency:

Will your child bring an epipen, rescue inhaler, or other rescue medication to Rising Tide? (Note: If yes, the Rising Tide Director will contact you to create a safety plan for storing and administering your child's rescue medication during Rising Tide in case of emergencies. If a rescue medication is administered, the parents and/or emergency services will be called immediately.) Yes No Not Applicable

Does your child have any struggles that we need to be sensitive towards such as learning differences, anxiety issues, trauma, sensory sensitivities, etc.?

Parent / Guardian Information

Name of Parent/Guardian (1)

Phone

This address will receive a confirmation email

How often is Parent/Guardian (1) able to volunteer to serve at Rising Tide?

Once per month Twice per month Once per semester Unable to serve

Name of Parent / Guardian (2)

Phone

How often is the Parent/Guardian (2) able to volunteer to serve at Rising Tide?

Once per month Twice per month Once per semester Unable to serve

Which is the best number to call in case of emergencies:

Drop Off / Pick up Safety

Names of Persons who are allowed to drop off/pick up your child:

Is there anyone who is NOT allowed to drop off/pick up your child?

Communication

Crossway Wilmington uses Breeze, a church management software, to communicate with families through SMS messages and emails. Rising Tide sends out regular ministry updates through text and email to keep parents informed about special events, emergency cancellations due to weather, and reminders about theme nights. By selecting "Yes" below, I am consenting to receive SMS messages from Breeze regarding information and announcements for Crossway Wilmington. I understand that message and data rates may apply and message frequency varies. I can opt out by responding STOP at any time. For support I can text HELP to 87447. Please review the Breeze Privacy Policy and Terms of Service available at breezechms.com for more details.

Do you consent to receive SMS texts and emails from Crossway Wilmington through Breeze?

Yes, I consent No, I do not consent Emails only

First Aid & Medical Release

In the event that I cannot be reached in case of emergency, I recognize that there may be occasions where the child named above, may be in need of first aid or emergency medical treatment as a result of an accident, illness, other health condition, or injury. I do hereby give permission for employees or volunteers at Crossway Wilmington to seek and secure any needed medical attention or treatment for the child named above, including hospitalization, if such need arises. In doing, so I agree to pay all fees and costs arising from this action to obtain medical treatment. I give permission for attending physician(s) and other medical personnel to administer any needed medical treatment, including pain management, anesthesia, and surgery. I agree to pay for any medical treatment. I understand that a responsible adult from Crossway Wilmington will remain with my child while they are receiving medical treatment until I can be reached.

Do you agree to the First Aid and Medical Release?

Yes, I agree

Photo Policy & Release

Crossway Wilmington occasionally displays photos of Rising Tide students on Sanctuary announcement screens to promote events or celebrate achievements. To protect student privacy, we will not post photos with identifiable faces on social media or our website. With parental consent, we may use less identifiable photos, such as those taken from the rear or side, for online ministry promotion.

Do you consent to allow Crossway Wilmington to use photos of your child taken from rear or side profiles on our website or on social media for purposes of promoting/celebrating the ministry?

I consent I do NOT consent

Digital Signature:

In consideration for allowing the participation of the child in the activities of Rising Tide at Crossway Wilmington, I represent that I am the parent/guardian of the child listed above who is under 18 years of age. This authorization will remain in effect two years from the signature date. Please type your full name with today's date as your digital signature.

Additional Information

Do you have any comments, suggestions, or prayer requests for the upcoming year that you would like to share?

Thank you for completing the Rising Tide Registration Form!

The information you provided will help us provide a learning space where kids feel loved, safe, and comfortable to be themselves. We praise God for the privilege of spending time with your family as we grow in the grace and knowledge of our Lord Jesus Christ together! If you have any questions or concerns, please contact Alicia Zander at (910) 512-2224 or email at RisingTide@crosswaywilmington.org.

2025-2027 Rising Tide Student Registration

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