2023 Midwest Teen Prom Registration Form

Registration Form
Parent Name *

First Name Last Name
Full Name of Prom Attendee 1 *

Full name AGE; Are you a Senior?
Full Name of Prom Attendee 2

Full name AGE; Are you a Senior?
Full Name of Prom Attendee 3

Full name AGE; Are you a Senior?
Full Name of Prom Attendee 4

Full name AGE; Are you a Senior?
Phone/Payment type *

Phone number What payment method will you use?
Family Name/Sabbath Services Attendance *

Family Name Total Sabbath Services Attendance from your group
Social Attendees *

Total number of Friday night attendees for the pizza social if you are planning to attend Will you be attending the Sunday Sports activity? If so fill out the forms below for each attendee. You may choose one option for each sport activity.
Sunday Sports activity options for Attendee 1:

Recreational Volleyball Competitive Volleyball Recreational Basketball Competitive Basketball Girl's Basketball
Sunday Sports activity options for Attendee 2:

Recreational Volleyball Competitive Volleyball Recreational Basketball Competitive Basketball Girl's Basketball
Sunday Sports activity options for Attendee 3:

Recreational Volleyball Competitive Volleyball Recreational Basketball Competitive Basketball Girl's Basketball
Sunday Sports activity options for Attendee 4:

Recreational Volleyball Competitive Volleyball Recreational Basketball Competitive Basketball Girl's Basketball
E-mail
example@example.com
If one of the above attendees is graduating from High School this year, please go to the next tab and fill out the Senior Questionnaire.

Cost is $50.00 per person.

If you have any questions please send them to sabrinamassie13@gmail.com

Looking forward to seeing you at the Prom!
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