Youth Registration Form

Youth Registration Form
(Please submit one form for each youth in our group.)

* Indicates required field

Name *

First

Last

Current Grade in School *

Email *

Date of Baptism (if applicable) *

Name of Parent or Legal Guardian *

First

Last

Address of Parent or Legal Guardian *

Line 1

Line 2

City

State

Zip Code

Country

Email of Other Parent (if applicable) *

Phone Number of Other Parent (if applicable) *

Allergies or other medical conditions of which we must be aware: *

Yes No

Please explain allergies or medical conditions and suggest safe/appropriate snacks, or activities as applicable. *

Questions? Contact Katelyn Webster, Youth & Young Adult Minister, E-MAIL

Birth Date *

School Attending *

Phone Number *

Date of Confirmation (if applicable) *

Email of Parent or Legal Guardian *

Name of Other Parent (if applicable) *

First

Last

Address of Other Parent (if applicable) *

Line 1

Line 2

City

State

Zip Code

Country

Interests and Favorite Activities *

Emergency Phone Number during Church Activities *

If the parent(s) would be willing to volunteer to help the Youth Ministries, please describe in what way. *

Submit (for one youth at a time)

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Youth Registration Form(Please submit one form for each youth in our group.)

Youth Registration Form
(Please submit one form for each youth in our group.)