2026/27 Afterschool Program Registration - Port Nelson United Church

Join us for Terrific Tuesdays, a fun and engaging afterschool program for children in from SK to Grade 7! Led by Mark Ruhnke, Director of Music, and Jocelyn Birkes, Developer of Children and Youth Ministry, each Tuesday brings opportunities to learn, create, make friends, and have fun.

Over the past two years, our Terrific Tuesdays participants have explored music through singing and playing the ukulele, learned and performed dances, created artwork and cards for members of our community, cooked and baked delicious treats, made pies, prepared treats for local shelters, and even had the opportunity to perform in a play called Daniel(lle) and the Lions Den!

There is always something new to discover at Terrific Tuesdays. Come connect with friends, explore your creativity, learn new skills, and have some fun along the way!

Tuesdays from 4:00–5:30 p.m.
Beginning Tuesday, September 22 and running until Tuesday December 15.

A new term will begin in January 2027.

After School Program Registration - 2026/27

Parent First Name*
Parent Last Name*
Address*
Street Address Address Line 2 City Province Postal Code
Phone*
Parent Email*
Emergency Contacts
Emergency Contact #1 Name*
Emergency Contact #1 Phone*
Emergency Contact #1 Relationship to the Child*
Emergency Contact #2 Name*
Emergency Contact #2 Phone*
Emergency Contact #2 Relationship to the Child*
Authorized Pick Up Person
Authorized Pick Up Person Full Name*
Authorized Pick Up Person Relationship to the Child*
Authorized Pick Up Person Phone*
Are you planning to come weekly or are there any current planned absences (list below)?*
Guardian’s Permission*
I declare that the health of the children listed within my registration is suitable for church related activities and programs. I permit the staff and volunteers of Port Nelson United Church to engage in on-site medical care as deemed necessary and to use their judgment in determining the extent of immediate medical care required for this child including using the emergency service of a hospital. As well, I agree to not hold staff or volunteers of Port Nelson United Church liable for accidents or misfortune that may occur to the (these) child(ren) (knowing that every reasonable precaution will be taken by staff and/or volunteers to ensure the (these) child(ren) welfare and safety). I also agree that photographs (without name) of this (these) child(ren) may be used in promotional materials and on the Facebook Page of Port Nelson United Church and shared with others. Further I agree that this child(ren) address, telephone number and email address will be added to the church rolls for communication purposes.
- I Accept
After School Program Attendee(s)
How many children are you registering for the After School Program?*
Child 1
First Name*
Last Name*
Birthdate*
Month
Day
Year
Grade of the Child in September*
Gender / Identity*
Health Card*
Health Conditions*
Allergies
Please list and food or environmental allergies if any.
Child 2
First Name*
Last Name*
Birthdate*
Month
Day
Year
Grade of the Child in September*
Gender / Identity*
Health Card*
Health Conditions
Allergies
Please list any allergies, medical conditions, or dietary restrictions:
Child 3
First Name*
Last Name*
Birthdate*
Month
Day
Year
Grade of the Child in September*
Gender / Identity*
Health Card*
Health Conditions*
Allergies
Please list any allergies, medical conditions, or dietary restrictions:

Tuesdays from 4:00–5:30 p.m. Beginning Tuesday, September 22 and running until Tuesday December 15.

After School Program Registration - 2026/27

Emergency Contacts

Authorized Pick Up Person

After School Program Attendee(s)

Child 1

Child 2

Child 3

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Tuesdays from 4:00–5:30 p.m.
Beginning Tuesday, September 22 and running until Tuesday December 15.