Round Hill Church Youth
This questionnaire serves as the 2023-24 school year Parental Consent, Medical Information, Photo Release , and Volunteer Forms. Please be sure to complete all sections of the form.
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Youth Last Name *
Youth First Name *
Date of Birth *
MM
/
DD
/
YYYY
Grade for 2022-2023 School Year *
School *
Youth Email Address
Youth Mobile Phone Number
Youth Address
Street *
City *
State *
Zip Code *
Does your youth have any allergies, dietary restrictions or medical conditions that would affect their participation in youth activities or are important for the Youth leaders to be aware of? *
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