Orange Youth Student Form 2023-2024

Orange Youth Student Form
Name*

First Name (What you want us to use at youth group)Last Name
Personal Pronouns*
If you chose "let me type":
Who May Use These Pronouns?*
If Other, Please Explain:
What is your gender? Choose as many as you like.*
If you chose "let me type":
Age*
Date of Birth*

MonthDayYear
Date
Phone Number*
Please enter a valid phone number.
Phone Carrier*
Verizon, AT&T, TMobile, etc.
Email Address*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
School*
Current Grade Level*
What do you like to do for fun? What teams, clubs, or other groups are you a part of?
My favorite local restaurant, coffee shop, or ice cream place is...
My favorite food is...
Right now, I can't stop listening to....(music, podcast, etc.)
Right now, I can't stop watching....(tv show, movie, TikTok, etc.)
Is there anything else you want us to know?
Your Grown-Up's Information
Name*

First NameLast Name
Personal Pronouns*
If you chose "let me type":
Phone Number*
Please enter a valid phone number.
Relationship*
Name

First NameLast Name
Personal Pronouns
If you chose "let me type":
Phone Number
Please enter a valid phone number.
Relationship
Name

First NameLast Name
Personal Pronouns
If you chose "let me type":
Phone Number
Please enter a valid phone number.
Relationship
Name

First NameLast Name
Personal Pronouns
If you chose "let me type":
Phone Number
Please enter a valid phone number.
Relationship
Community Agreement
While participating in Orange United Methodist Church's (OUMC) youth group activities, I will do my best to seek God, love others, and love myself through my attitudes, thoughts, and behavior.

In order to uphold those values, I agree to:
- Create a loving atmosphere through having a positive attitude and accepting others, while refraining from gossip, harmful language, and bullying.
- Strive to resolve conflict in a timely, mature, & loving manner.
- Respect instructions given by leaders.
- Keep leaders informed of my whereabouts.
- Stay in groups of at least 3 students.
- Refrain from public displays of affection and respect personal boundaries.
- Participate in all planned activities and give them my full attention, including by refraining from using personal electronics and cell phones.
- Refrain from possession or use of alcohol, drugs, tobacco, or vapes.
- Refrain from fighting, weapons, fireworks, lighters, or explosives.
- Refrain from illegal activity of any kind.
- Respect the facilities.
- Stay out of sleeping areas that are not assigned to you.
Student's Signature*

Clear
Today's Date*

MonthDayYear
Date
Upload a selfie to help us learn your name--This won't be posted anywhere, promise!*
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Orange Youth Student Form

Your Grown-Up's Information

Community Agreement