Life Teen Emergency Contact Form

Registration Form

Welcome! Thank you for joining us at Life Teen! We are excited you are here.
Teen Name *

First Name Last Name
Teen Phone Number

Area Code Phone Number
Teen Email
example@example.com
School *
Grade (as of August 2021) *
Gender *
What are you looking for in Life Teen? *
Dietary Restrictions *
Favorite Candy *
Teen Agreement:

I agree to abide by any and all rules communicated to me for any Life nights and events. If I fail to maintain the guidelines and expectations of the adults and my peers, I understand that there will be consequences for my actions, including being removed from the activity and being sent home at my parent’s expense. Basic rules/expectations include, but are not limited to the following: Respect for all adult leaders, peers, and all property; NO illegal drugs, alcohol, underage smoking, firearms, explosives, or other illegal substances; Males and females are to remain in separate sleeping spaces at all times; No inappropriate physical/sexual activity; Appropriate, modest attire is to be worn at all times.
I have read and agree: *

Yes
Parent/Guardian Emergency Contact 1
Full Name *

First Name Last Name
Email *
example@example.com
Mobile Number *

Area Code Phone Number
Relationship *
The information that you provide on this form is confidential and will be received by the Assumption Youth Minister. We will only use this information for the EDGE programme and the promotion of any useful opportunities for all participants who join the programm. No information provided to us will be shared to any other parties without consent of the individuals named on this form, unless in the event of an emergency. Should this be the case, then only relevant parties will have details shared with them.
Communication
Our primary method of communication is through Flocknote, a tool for texting and emailing. PLEASE click the links below to make sure you don't miss important information.

To get updates on Life Teen: Life Teen Updates

Social Media

Instagram: @aymstl
How can we be praying for your family? *
Should be Empty:

Registration Form

Parent/Guardian Emergency Contact 1

Communication