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Pathfinders Club Membership Application

I would like to join the NFSDA Falcons Pathfinder Club. I will attend club meetings, hikes, camping and field trips, missionary adventures, and other club activities. I agree to be guided by the rules of the club and the Pathfinder Pledge and Law.
 

Pathfinder Pledge

By the grace of God,
I will be pure, kind, and true
I will keep the Pathfinder Law
I will be a servant to God
And a friend to man
 Pathfinder Law
  1. Keep the Morning Watch
  2. Do my honest part
  3. Care for my body
  4. Keep a level eye
  5. Be courteous and obedient
  6. Walk softly in the sanctuary
  7. Keep a song in my heart
  8. Go on God’s errands
Registration Fee: $5
Club Dues: $150 a year or $15 month
Insurance: $0
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By checking Yes you have indicated you need help funding your pathfinder Dues, Trips, and other costs for pathfinders. Each parent is required to make some good faith effort to help out with a small amount towards the funding of there kids. Parents/Guardians are required to do volunteer work to help out with other duties. 
Please let us know your name.
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Please enter your phone number (615-XXX-XXX)
Please let us know your email address.
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Please enter the school you attend
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Must enter the street address
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Approval by Parents or Guardians

The applicant must be in at least the 5th grade to be a Pathfinder.  We have read the Pathfinder Pledge and Law and are willing and desirous that the applicant become a Pathfinder.  We will assist the applicant in observing the rules of the Pathfinder organization. In consideration of the benefits derived from membership, we hereby voluntarily waive any claim against the club or the Kentucky-Tennessee Conference of Seventh-day Adventists for any accidents which may arise in connection with the activities of the Pathfinder club.  As parents, we understand that the Pathfinder club program is an active one for the applicant. It includes many opportunities for service, adventure, and fun. We will cooperate:

  1. By learning how we can assist the applicant and his leaders.
  2. By encouraging the applicant to take an active part in all activities.
  3. By attending events to which parents are invited.
  4. By assisting club leaders and by serving as leaders if called upon.
  5. By supplying needed information on the Membership Application and Health Record.
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Parent or Guardian info

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Other Parent or Guardian info

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Medical Info

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Date of Last Immunization

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Authorization to Treat a Minor

I (we) the undersigned parent, Parents, or legal guardian of:
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In case of an emergency, I understand that every reasonable effort will be made to contact me. In the event that I cannot be reached, I hereby give permission to the physician selected by the adult leader in charge to secure proper treatment, including hospitalization, injections of medications, anesthesia, or surgery for my child.
 
As a parent or legal guardian of the above-named Pathfinder, I am in favor of him/her attending club functions and accept the conditions named. The health history given by me on this form (front and back) is correct so far as I know, and the person herein described has permission to engage in all prescribed activities, except as noted. In addition, I have read and understand the emergency authorization statement and give my full consent to the terms found therein. Permission for photocopying of this health record is granted.
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Pathfinder Pick-Up Authorization


The following individuals are authorized to pick up my child from Pathfinder meetings and other Pathfinder functions.
 
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All individuals must be at least 18 years of age and be prepared to show a picture
I.D. if he/she is not recognized by a staff member.
Any  changes  in this list must be made in advance, as your Pathfinder will not be
released to anyone without prior written authorization.
This is for the safety of your Pathfinder, and your cooperation is appreciated.
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Image Release Form
Seventh-Day Adventist Church
Kentucky-Tennessee Conference

I hereby consent and authorize the Kentucky-Tennessee Conference of the Seventh-Day Adventists, or its assigns, to photograph and publish pictures, audio, and video of me and/or my child(ren), and use my name and likeness and/or my child(ren)’s name(s) and likeness. I understand that photographs may be printed, placed on the organization’s various websites, and/or incorporated into promotional material such as brochures and videos.

I hereby waive any claim against the Kentucky-Tennessee Conference of Seventh-Day Adventists for any personal or emotional damage which may arise in connection with the use of these photographs, my name, or my likeness.

I understand the following:

    • Illegal or explicit photographs are NOT authorized under this agreement. Should this situation arise, the violating individual or parties are solely liable and are subject to all local, state, and federal laws.
    • I am releasing all recorded images, audio, and video for the express use of the Kentucky-Tennessee Conference of Seventh-Day Adventists.
    • Neither my child nor I will receive any compensation if our names or likeness is used by the Kentucky-Tennessee Conference of Seventh-Day Adventists.
    • The Kentucky-Tennessee Conference of Seventh-Day Adventists and its assigns will hold the copyright to all photographs, videos, and promotional material.
    • Should I desire copies of photographs, videos, or audio recordings, there may be a cost involved.
    • This release remains valid until revoked in writing.
If I am signing this form on behalf of a child, I certify that I am the parent or guardian of the child and am over 18 years of age. A copy of this form shall be considered valid and shall serve the same purpose as the original.
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Parent and Guardian Commitment

I have read and understood the Pathfinder Club Membership Application and have signed that application on behalf of the minor named on the application. I understand that while participating in or attending Pathfinder functions the child is subject to the rules, guidelines, policies, instructions, directions, and orders of the Falcons Pathfinder club and its staff. I agree that I will not interfere with the Pathfinder staff in the conduct of its duties while participating in or attending such events with my child; I agree to this because I understand that to do so will undermine the purpose of the Pathfinder organization.

It is my right and duty to inform the senior staff or director of the Pathfinder club immediately should I observe action taken by any Pathfinder or staff that I believe to be inherently dangerous or potentially harmful or inappropriate.

I understand that the participation of my child in the Pathfinder club is “at-will” and the club or I may remove my child from the rolls of the Pathfinder club at any time. I understand that this will not disqualify my child from future participation in Pathfinders although there may be a specified period of time for temporary disqualification should it be deemed appropriate. I understand that if I remove my child from the Pathfinder club or my child is expelled by the club I am not entitled to any reimbursement of funds paid for joining the Pathfinder club.

I agree to assist the club according to those items delineated in the Pathfinder Club membership application and handbook. I further agree that my signature on the application is my contract to pay fees associated with the Pathfinder club and those fees must be paid as agreed unless waived by the Director or Treasurer as a result of my specific request for financial waiver or assistance.

I understand that if I seek a financial waiver or assistance the information I supply to the director will remain the property of the Pathfinder club. The Pathfinder club will use this information only for the purpose of considering my request for financial assistance and will not without my foreknowledge share this information with any other department of the church or outside entity public or private. I understand that in some cases as a result of financial accountability to the church Pastor(s), Treasurer, and/or board may be made aware of this information and that they will not use the information for any purpose other than auditing and will not share the information within the church or make the provided information public.

I understand that the medical information provided to the club during this process will remain confidential. The information will be carried on and to all outings and campouts and will be made available to any Pathfinder or conference medical officer or any medical or emergency professional in the case of an accident or emergency. The information will be shared with doctors and medical facilities as required for the treatment of injury or illness.

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