Youth Student Registration 2018 - 2019 (6th - 12th grade)
Student's Name/Nickname/Preferred Name *
Your answer
Birth Date - including birth year. *
MM
/
DD
/
YYYY
Age *
Your answer
Grade and Name of School This Fall
Your answer
Student email
Your answer
Student cell #
Your answer
Do you text? y/n
What is the best way to get in touch with you?
Your answer
Mailing Address - including city and zip
Your answer
Tell us about you! What are your special gifts, talents, or interests?
Your answer
Parent/Guardian #1 Name and email *
Your answer
Parent/Guardian #1 phone - please indicate if home or cell. *
Your answer
Parent/Guardian #2 Name and email
Your answer
Parent/Guardian #2 home phone - please indicate if home or cell.
Your answer
From time to time, we will need parent chaperones for outings or special events. Would you be able to help out?
Would you be available to help out in Sunday School and Youth Group as an adult leader? (NOTE: If you have a child in CRASH!, we would ask you to help out with our eMERGE Youth – and vice-versa.
I give permission and consent for photographs or video footage of my student to be published and used by St Francis Church to illustrate and promote St. Francis Church and/or its ministries. For the safety and security of your student, we will never print your student’s name with his/her photo or video. *
What special activities for Crash and/or eMERGE are of interest to you (Youth)? *
Required
Other Activities
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