Men of Integrity TN

Registration Form
Youth Name*

First NameLast Name
Youth Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Youth Mobile Number*

Area CodePhone Number
Youth Email
What type of skill would you like to learn?
Choir, ushers, etc.
Current School Name
Projected Graduation Date
Month/Year
Extra-Curricular Activities
Sports, Instumentatiiom, etc.
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Mobile Number*

Area CodePhone Number
Parent/Guardian Email
example@example.com
Transportation

Yes pick up for SaturdayNo Pick Up, I will drop off my kid(s)
Medical Information:
Extra:
Should be Empty: