GEMS 2023-24 Registration

September 5th through April, 6:30 p.m. | Please fill out this form and click submit. GEMS Girls' Club is for girls ages 6+ and mentor women of any age. Club dues are $30 per member annually and may be paid in person to GEMS Treasurer Emily Duma or another member of the GEMS Mentor Team. Email gems@portagechapel.com with questions about payment, etc.
Interested in trying out GEMS before committing? Join us for a week or two to see what GEMS is all about! Payment is requested by the third meeting you/your daughter attends. Email questions to gems@portagechapel.com. We hope to see you soon!

GEMS membership dues are $30 per member annually, payable to Treasurer Emily Duma or any member of the GEMS mentor team. Cash and check payments are accepted.
 
 
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Family Information

 
 
 
 
 
 
Medical/Health Information

 
 
 
Please list any health issues that may affect the activities, food consumption, well-being or medical treatment of the listed GEMS member, e.g. conditions like asthma, a physical handicap, allergies, heart condition. Also indicate any medications the registrant may be taking.
 
 
 
 
Adults: print, complete, and submit a PCC background check permission form to GEMS leadership in order to be involved with GEMS activities. If you have completed this form for PCC in the past, background checks are good for 3 years from the last submission date. 

Check your confirmation email for form link. 
Permissions

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Portage Community Chapel and its representatives may take and use photos, videos, or other imaging formats of children and adults participating in PCC-affiliated ministries and activities. Participation in these activities constitutes agreement for use of such images for website, facebook, advertising, and other related purposes.

Every activity sponsored by Portage Community Chapel is carefully planned and adequately supervised. However, even with the best of planning and precaution, unforeseen events can occur. By signing this form, I agree to assume and accept all risks and hazards inherent in church-related social activities, both at the church and other locations selected by the church. I also agree not to hold this church or its employees or volunteer assistants liable for damages, losses or injuries to the person or property of the participating members listed above. Every attempt will be made to contact a child's parent or emergency contact I have listed on this form. However, if I/they cannot be located, I hereby give my permission to the physician or dentist selected by the church leadership to secure proper medical treatment for myself or my child, as deemed necessary. I understand that my electronic signature below is both a medical and liability release.
 
 
 
 
 

Description

September 5th through April, 6:30 p.m.
Please fill out this form and click submit. GEMS Girls' Club is for girls ages 6+ and mentor women of any age. Club dues are $30 per member annually and may be paid in person to GEMS Treasurer Emily Duma or another member of the GEMS Mentor Team. Email gems@portagechapel.com with questions about payment, etc.