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Campbell Church

    SEED PROJECT Interest & Agreement Form

We are excited to have your family join us for our activities. 

Our hope is that what we do here is beneficial to your whole family.  In order to participate in this program, please carefully read the following terms and fill out the end of this form clearly and completely.   We have a few guidelines and rules to ensure everyone’s safety including that of the participant. 


·      We ask that all participants be encouraging to one another, behave safely, responsibly and appropriately at all times.  Each participant is asked to respect the SEED staff and volunteer members, other students and NCM property and facilities.   (This includes: No lighters, fighting, weapons, fireworks, explosives, alcohol, drugs, or inappropriate behavior will be permitted.) Respect and comply with event schedules/rules, obey state, national, and federal laws. Thanks for helping us provide a safe environment. 

·         We ask that each family commit to attending all the classes during each session, a session is usually 5-6 classes. 

·         Please arrive on time with your class materials in-hand and ready to start courses.

·         Spend time during the week reviewing materials and lessons that SEED provides.

·         Please sign in and out each time as to help us keep track of the participants present.  If you need to leave before classes are over at their scheduled times, please check in with an SEED staff member first. Once students sign out, NCM (New Creation) will not be responsible for students after classes end.

·         Do Not bring any food or drinks to classes, particularly in music courses in order to keep hands and instruments clean and dry during play and practice.

·         Take care of one’s own personal belongings. NCM will not be responsible for lost items.



·         Please review terms listed in this agreement with their children and will be responsible for ensuring all rules are met.

·         Drop off and pick up children promptly after classes are over. NCM does not provide childcare and are not responsible for students after classes end. All students who do not sign in will be considered as “absent” and therefore SEED staff will not be responsible for your child that day.

·         Please help your child throughout the week by encouraging them to review course materials and lessons provided.

·         Do not ask SEED teachers to provide additional free lessons outside of predetermined times.



By signing this document, I acknowledge that if anyone is hurt or property damaged during my minor

student’s or my own participation in activities, I and/or my student may be found by a court of law to have waived any right to maintain a claim or lawsuit against NCUMC on the basis of any claim which has been released herein.   I am informed of the activities offered by New Creation United Methodist Church (NCUMC)  located at 1675 Winchester Blvd, Campbell, Ca.  As the parent(s) or legal guardians(s) of my child, I hereby consent for my child to attend & participate in all activities provided by this Church, NCUMC!  In the unlikely event of an emergency, I do hereby authorize any adult acting on behalf of New Creation United Methodist Church (NCUMC) as agent(s) for the undersigned, to consent to medical treatment unless otherwise noted. I agree to pay any costs associated with the medical treatment.  I also understand that for promotional or marketing purposes, NCUMC reserves the right to use any audio, video, and/or photography of events facilitated by NCUMC.


I, _____________________  (Print Student’s Full Name), agree to the terms listed the above.


Student Signature: ______________­__________________    Date: ______________________


I, _____________________  (Print Parent’s Full Name), agree to the terms listed above.


Parent Signature: _________________________________    Date: _____________________





Participant’s Name

1.    Legal Name:_______________________________________________ Birthdate: ______________________            


Gender:_________________     School:  ___________________________  Grade:_____        T-Shirt Size: XS S M L XL XXL


2.    Legal Name:_______________________________________________ Birthdate: ______________________            


Gender:_________________     School:  ___________________________  Grade:_____        T-Shirt Size: XS S M L XL XXL


Parent/Legal Guardian Name (S):_____________________________________________ Live w/Participant: Yes or No                                                                     

Mobile Phone: ___________________________  Email Address: _______________________________________________


Address: ____________________________________________________________________________________________

                                                                                    City                                                      State                Zip

Home Phone:___________________________                                                          


In case of an Emergency (other than parent): ______________________________________________________________

                                                                                     First and Last Name                  Phone Number

*Note: This form can be used for up to 2 participants who all live at the same address and have all the same emergency & medical info.  Please use another form if you have 2 or more participants or any of the info does not match.  Thanks!


Course Information:


Which of the following courses would you like to attend: (Circle all that apply)


SPORTS / MUSIC on SUNDAYS 3:00pm-4:30pm                                                        YES                NO


TUTORING / HOMEWORK HELP on WEDNESDAYS 6:00pm-7:30pm :                            YES                NO


PARENTS ESL CLASS on SUNDAYS 3:00pm-4:30pm                                                  YES                NO


PARENTS ACTIVITY on WEDNESDAYS 6:00pm-7:30pm                                             YES                NO


Have you taken any music courses previously?


If so, how Long have you been playing?


If any, what sports have your played in the past and how long?


Any other feedback or information you would like to provide us (ex: allergies, activities you would like to see, diabilities, other kids that your kids would like to be with)


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