Grace in Action Youth Serve Night Registration
Register your youth and choose your attendance plan (drop off or parent/guardian stays) for the next every-other-Saturday event.
Which event date or cause are you registering for?
*
Please Select
October 24 – Community Food Drive
November 7 – Blessing Bags for Shelters
November 21 – Holiday Card Making
Other/Upcoming Event (will update as needed)
Child/Youth Full Name
*
First Name
Last Name
Child/Youth Age
*
Child/Youth Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Parent/Guardian Full Name
*
First Name
Last Name
Parent/Guardian Email
*
example@example.com
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Allergies or Dietary Restrictions
Relevant Accommodations or Medical Information Needed for Safe Participation
Authorized Pickup Person(s)
*
Attendance Plan
*
Drop off
Parent/guardian will stay
If staying, please enter the adult’s name who will remain at the event
Do you grant permission for photos and/or video of your child/youth to be taken and used for Grace + Faith Co. community purposes?
*
Yes
No
Acknowledgements
*
I understand the event includes age-appropriate activities, a short faith-centered devotional, snacks/drinks, and a hands-on community service project.
If I choose drop-off, I will remain reachable by phone during the event.
I understand that respectful conduct is expected, and a guardian may be called for early pickup if needed.
Electronic Guardian Signature
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Register
Register
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