Youth Registration

1
Jr. Youth will be for grades 6-8.

Sr. Youth will be for grades 9-12.

Youth Kick-off for all Youth is Wednesday, September 11 from 6:30-9pm!
2
Names of YouthPlease enter all children from your family attending Youth this year
CHILD 1 - First & Last Name
Grade
CHILD 2 - First & Last Name
Grade
CHILD 3 - First & Last Name
Grade
CHILD 4 - First & Last Name
Grade
3
Parent/Guardian Name* This field is required.
First Name
Last Name
4
Parent/Guardian Phone Number* This field is required.
Area Code
Phone Number
5
Parent/Guardian Email* This field is required.Please enter your email address below and choose whether you would like to receive weekly update emails. You may opt out anytime.
Please enter your email
Please Select
Please Select
Yes, I would like to receive the weekly updates
I am already signed up to receive the weekly updates
No, I do not want to receive the weekly updates
Would you like to receive the weekly email updates?
6
Secondary Emergency Contact* This field is required.Please list a person outside of your home (close friend, family member not living in your household, etc) who we could contact in case of an emergency and we cannot contact the Parent/Guardian listed above.
First and Last Name
Phone Number
7
Allergies & Additional InfoPlease let us know any useful additional information. Allergies? Medical needs? Etc...
Huge
Large
Normal
Small
Ok
Ok
8
Do we have your permission to take your child(ren) on the church bus to off campus events/activities?* This field is required.Our bus is always driven by a licensed, responsible driver.
YESNO
9
Do we have your permission to post your child(ren)'s image on social media?* This field is required.Example: Instagram feed, Instagram stories, etc
YESNO
10
Parent/Guardian Signature* This field is required.By signing below I verify I am the parent or guardian of the above registered child and all information is accurate.
Clear
Should be Empty: