Youth Group Registration Form
For high school youth (Grade 8 to 12). STARTS ON NOVEMBER 18
Child's Name *
Your answer
Child's Gender *
Child's Date of Birth *
MM
/
DD
/
YYYY
Child's School *
Home Address *
Your answer
Parent's/Guardian's Name *
Your answer
Parent's/Guardian's Email Address *
Your answer
Parent's/Guardian's Phone *
Your answer
Allergies or other medical conditions (Type "None" if none) *
Your answer
Emergency Contact *
Your answer
Emergency Contact Phone *
Your answer
Poll: Which days work for your family? (please check all that apply) *
Required
Support from parents/ guardians (please check all that apply) *
Required
Consent *
Required
Submit
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