Middle School/High School Ministry Registration Form

2023-2024 Middle School/High School Ministry Registration Form

PLEASE COMPLETE A SEPARATE FORM FOR EACH CHILD REGISTERED.
Child's Name*

First NameLast Name
Child's Grade in School*
Child's Date of Birth*

MonthDayYear
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Any Allergies?
Primary Parent Contact's Name*

First NameLast Name
Primary Contact Phone Number*

Area CodePhone Number
Primary Contact's Email Address*
Additional Parent or Authorized Adult

First NameLast Name
Secondary Phone Number*

Area CodePhone Number
Secondary Email Address
Assistant for yearly events and activities (setting up and helping with coordination)When things settle a bit in my schedule I can help.
Any concerns you would like to share regarding your child?
Should be Empty:

2023-2024 Middle School/High School Ministry Registration Form