Register for any youth events and dates/Regístrate para los eventos y fechas.

Register for any youth events and dates/Regístrate para los eventos y fechas.
Your Name/ Tu nombre*

First Name/ Nombre Last Name/Apellido
Parent/Guardian Name-Nombre de padre o tutor*

First Name/NombreLast Name/Apellido
Address/ Dirección

City/Cuidad State / Estado

Postal / Zip Code- Código postal
Email*
example@example.com
Phone Number/ Numero telefonico*
Do you need accommodation services/ Alguna incapacidad?

Yes-SiNo
Please enter what type of accommodation services do you need/ Que tipo de incapacidad tiene?.
Emergency Contacts/ contacto de emergencia *
Education Level/Grado escolar
School Name/ Nombre de la escuela
Birthdate/ Cumpleaños*

MonthDayYear
Date
Photography and Video/ Fotografía y Video

I hereby acknowledge that the information given above is accurate and I give permission to the community for the use of my photographs that are taken by staff in order to use for social media only for the church (EastEndFellowship)

Yo acepto el uso de cualquier foto o video tomada de mi, solo para uso de la iglesia EastEndFellowship. Mis datos son correctos.
Signature/ Firma

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