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New Life Youth Group Online Registration
Please fill in the form completely for EACH registering child
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* Indicates required question
Child's Name
*
Your answer
Child's Grade for 2017-18 school year
*
Your answer
Child's Birthdate (inc. year)
*
Your answer
Parent Name(s)
*
Your answer
Parent Phone number
*
Your answer
Parent email
Your answer
Emergency Contact Name and Phone Number (please choose someone other than the registered parent- we will contact parents FIRST in the case of an emergency)
*
Your answer
Child Allergies and/or medical conditions
*
Your answer
Child's BC Medical Card #
*
Your answer
Do you allow pictures and/or video of your child, taken during New Life Youth Group weekly Nights and events, to be used for New Life Youth Group promotional purposes on the New Life Youth Group Facebook page and/or New Life Community Fellowship website?
*
YES
NO
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