2026-2027 YOUTH GROUP REGISTRATION FORM
PLEASE COMPLETE ONE PER YOUTH MEMBER
YOUTH MEMBER INFORMATION
Youth Member Full Name
*
First Name
Last Name
Gender
*
Male
Female
Date of Birth
*
-
Month
-
Day
Year
Birthday
Youth Member's Email Address (if applicable)
example@example.com
Youth Member's Cell Phone Number (if applicable)
Please enter a valid phone number.
Format: (000) 000-0000.
Youth Member's Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Grade last year:
*
Enter youth member's grade last year.
Name of church you attend:
*
Please provide the name of the church you attend.
MEDICAL INFORMATION: Please list all pertinent medical information (for example, allergies, medications, physical impairments, or any other information necessary in an emergency situation). Explain fully:
*
Enter child's medical information if none, enter NONE.
LEGAL GUARDIAN INFORMATION
Legal Guardian's Full Name
*
First Name
Last Name
Legal Guardian's Full Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Legal Guardian's Cell Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Legal Guardian's Home or Work Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Legal Guardian's Email Address
*
Enter Email Address
Emergency Contact Phone Number
Type in your name and a valid phone number that you can be reached in case of an emergency.
PARENTS HAVE RECEIVED AND READ THE FOLLOWING POLICIES AND SIGNED BELOW
2026-2027 Parental Release Forms Checklist
Saint Francis of Assisi Church, Inc. in Grove City Florida
PLEASE CHECK THE BOX NEXT TO EACH OF THE FORMS THAT YOU SIGNED ABOVE.
Submit
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