2019-20 Club 56 Registration
Come one, come all: register for another great year of Club 56 at Zion!
(Optional) If you'd like, share three words that describe your youth:
Your answer
First Name of Youth *
Your answer
Last Name of Youth *
Your answer
Grade *
Birthdate *
e.g. 2/10/1995
Your answer
Preferred Email Address *
This is our main mode of communication for the year. Please provide at least one email which will be checked regularly.
Your answer
Secondary Email
If you have an additional email you'd like messages and announcements be sent to.
Your answer
Contact Info: Primary Parent(s)/Guardian(s) *
Name, Mailing Address, Home & Cell Phone
Your answer
Contact Info: Secondary Parent(s)/Guardian(s)
Optional: Name, Mailing Address, Home & Cell Phone
Your answer
Emergency Contact *
Include Name, Phone Number & Relationship to Youth
Your answer
As my youth comes to Club 56 this year, he/she... *
Check all that apply
Required
Small Group
During Club 56, youth will be welcomed into a small group for discussion and activities. Who in your child's grade would make him or her feel comfortable and be a good influence? If possible, list 2 to 3 names.
Your answer
Parent Involvement
As I Parent/Guardian, I would like to contribute to this Club 56 year by... *
Check all that apply
Required
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service