2026-27 Youth Ministry Registration Form

Youth Ministry Registration Form

Thank you for registering your child for Youth Group! Please complete the form below so we can provide a safe, organized, and enjoyable experience while keeping families informed throughout the year.
Child's Full Name:

First NameLast Name
Grade:
Child's Date of Birth:

MonthDayYear
Date
Child's Email Address:
example@example.com
Home Address:

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Parent/Guardian Full Name:

First NameLast Name
Parent/Guardian Phone Number:
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email Address:
example@example.com
Emergency Contact Name:

First NameLast Name
Emergency Contact Relationship to Participant:
Emergency Contact Phone Number:
Please enter a valid phone number.Format: (000) 000-0000.
Photo & Video Release: I grant permission to St. John's Lutheran Church & School to photograph and/or record me (or my child) and to use these images and recordings for ministry, educational, promotional, and communication purposes, including but not limited to print publications, the church and school website, social media, livestreams, and other official materials. St. John's Lutheran Church & School will make reasonable efforts to use these images respectfully and appropriately and will not identify minors by their full name in publicly available materials unless additional permission has been granted.
Allergies? If yes, please list any below:
Parent/Guardian Signature:
Today's Date:

MonthDayYear
Date
Should be Empty: