Contact information
LAC Youth Registration form if you have any question contact us to
youth@lindenalliance.com
* Required
Email address
*
Your email
Student Name
*
Your answer
Email
*
Your answer
Address
*
Your answer
Grade
*
Your answer
Phone number
*
Your answer
Allergies
Your answer
PARENT CONTACT
Name
*
Your answer
Cellphone number
*
Your answer
Parent Email
*
Your answer
Emergency Contact. Name, Phone Number, Relationship to the Teen
*
Your answer
All LAC Youth are expected to:
* Be Responsible for their Guest
* Remain with the group at all time
* Be respectful to all attendence
My Parent and I Understand the guidelines above and realize, if violetd, actions deemed necessary by the youth Leader will be taken wich may include parental contact
Parent and Teen Name
*
Your answer
Photograpgy / Videography Waiver I Understan that my child may be photographed or recorded on video during the corse of youth ministry events. By The initialing Below I provide consent for their image to be used in either print, electronic, or video form for the promotional purpose of fututre retreats and youth group activities.
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No
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A copy of your responses will be emailed to the address you provided.
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