AGAPE Youth Center

Information and Registration Form

First Baptist Comunidad Cristiana's AGAPE Youth Center (AYC) is hosting an afterschool program for kids 1st - 12th grade from January 8th to June 2025 on Tuesdays, Wednesdays, and Thursdays from 4:15-5:45 PM.

To enroll, please complete the registration form for each child and sign the waivers below.
If you have any questions about AYC, please contact the church office at (509) 248-4434.

Please complete these forms promptly. We must have this documentation for your child to participate.

Media Release

This media release is for the AGAPE Youth Center. Youth may be photographed and their photos posted to websites such as Facebook, Instagram or Twitter. Youth may also be photographed and televised during local newscasts.

Signatures below include permission for my child/youth to be photographed as part of the AGAPE Youth Center afterschool program.

Registration Form and Media Release

Child 1

Child 2

Child 3

Child 4

Parent or Guardian


AGAPE Youth Center

Hold Harmless Agreement

I hereby consent to the participation of my child in the AGAPE Youth Center program. I fully understand that any participation in the AGAPE Youth Center afterschool program exposes me to the risk of personal injury or property damage. I hereby acknowledge that I am voluntarily participating in this program and agree to assume any such risks.

This form must be signed in order for the child to participate in the AGAPE Youth Center.

On behalf of my child and in consideration for being permitted to participate in the program, I, my agents, heirs, marital community, if any, and legal representatives hereby release, promise to defend, indemnify, and agree(s) to protect, save and otherwise hold harmless FBCC and the AGAPE Youth Center, it's boards, elected and appointed officials and employees, and agents from and against all claims, demands, and causes of action of any kind or nature, including the cost of defense, or liability arising from or relating to this program, the grant of the registration, or any use of FBCC facilities related to this registration and/or actions in connection with my participation in this program including but not limited to personal injury, property damage or death, unless caused solely by the negligence of the FBCC.

BY SIGNING, I ACKNOWLEDGE I HAVE CAREFULLY READ THIS RELEASE AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT IT IS A FULL RELEASE OF ALL LIABILITY ADN I SIGN IT ON MY OWN FREE WILL.

Parent or Guardian Signature


Transportation Release Form

First Baptist Comunidad Cristiana AGAPE Youth Center is hosting an afterschool program for 1st grade through 12th grade from January 8th through June 2025. AYC staff and volunteers may sometimes need or want to take your child on a field trip, or you may wish to have your child ride the AYC van to and/or from the program. Otherwise, you are responsible for providing transportation for your child.

If you wish to allow your child to ride in AYC provided transportation, please read and sign below.



AGAPE Youth Center

Transportation Agreement

Due to our program growing in both the number of children in the program and the number that need transportation, this transportation agreement must be put into place in order for the program to continue to run smoothly and effectively. In order to facilitate transportation, we are training another church member, Gene, to handle driving children to and from church, so I can handle other responsibilities.
The following rules must be observed in order for everything to run smoothly:

1. Because of variations in pick-up and drop off times due to changes in the number of children riding the van that day, children must be ready to go (with their shoes on) and looking for the van at least 15 minutes both before and after the scheduled pick-up time.

2. We will wait only 2 minutes at each location for the child before moving on to the next spot.

3. From 2:45-4:15 PM the day of the program, the driver, Gene, will not be responding to texts or phone calls from parents. He will make all the stops as scheduled by Stacey.

4. It takes about 45 minutes to 1 hour for all the kids to be dropped off. Your child will be dropped off in reverse order of how they were picked up.

5. Every child needs to have their own way into their house because kids in different classes may arrive at different times.

6. If a child cannot be home alone, someone needs to be there at the designated time to be ready to pick up the child. Otherwise, we cannot be responsible for taking them home and they will need another ride.

7. If you drop off any child and/or friend, you will be expected to pick them up if you haven't confirmed a ride home the night before.

8. If these guidelines are not followed or are violated multiple times, that may result in us not being able to pick up/drop off your child for a period of time, or indefinitely, depending on the situation.
Communication between you and me is extremely important to making this program work. All communication regarding riding the van must be discussed with me the night before. Here are the guidelines for situations or changes when I need you to communicate with me:

1. If your child normally rides the van, you must call me and tell me that he/she will not be riding the van or will not be attending or we will pick them up.

2. If you plan to bring someone new along with your child. However, I cannot guarantee a ride for that child unless you have pre-arranged it with me the night before.

3. If your child will be dropped off at the program and doesn't usually need a ride home, but will need an unplanned ride home, or vice versa.

4. If your child needs to be picked up or dropped off at a different location than usual.

5. If you need your child home by a specific time, let me know if that is practical, given the order we drop off. If it isn't practical or possible for us to do that, then please make arrangements to pick up your child.

6. Or if any other changes are needed, please communicate with me.

* I understand that sickness/emergencies/issues can happen the day of and can be dealt with on a case-by-case basis.
I understand these transportation guidelines and agree to follow them.

AGAPE Youth Center

Authorized People to Pick Up My Child

Below are the authorized people who can pick up my child from AYC functions who have not already been documented in other registration material:
I understand that ONLY those listed on this sheet or other registration material can pick up my child. If someone comes to pick up my child who isn't on this sheet or documented elsewhere, AYC will not be able to release that child to that person unless we get the expressed permission of the parent/guardian who filled out this paperwork. Other authorized people for pick up can be added to this document, but it must be dated and re-signed for any additions.

AGAPE Youth Center

Rules and Expectations

1. Show Kindness 
- Being polite by saying “please, thank you”
- Offering to help others
- Taking turns, sharing

2. Show Respect
- By listening and not talking when others are talking
- When a leader asks you to do something, do it
- Ask permission before leaving an area
- Take care of property, clean up your trash
- No bullying/name calling, fighting, yelling or cussing

3. Positive Attitude
- Try new activities, believe that you can do it!
- Ask to talk to a leader if you have a question or are having a hard day
- No complaining or whining
- Have FUN!
 Disciplinary Process
1. Verbal warning; reminder of rules.
2. Verbal warning, talk about how the child can change their behavior.
3. Call parents and correct behavior.
4. Call parents and take home.

If a child is taken home 3 times because of behavior then they will not be able to return to the program. We desire for children to want to be here, which is shown by them choosing to follow directions and to have fun.

NOTE: We will work with children who are choosing unacceptable behavior, helping to guide them to choose the appropriate behavior. Leaders do have the right, however, to skip steps in the disciplinary process if they decide it is necessary. For example, blatant disrespect and refusal to do what is asked and running away from leaders will result in immediately being sent home.
I have read, understand and agree to follow these rules and expectations.





Grant Data Collection

The AGAPE Youth Center is made possible through funding provided by a number of grants. These grants often request data collection in order to evaluate their impact. You may answer the questions below to provide this data. This section is optional.