19-20 Kirk Youth Group Info Form
For your safety, we ask that this form be filled out before participating in any off-campus youth activities. We would like to think that nothing bad would ever happen, but we also don't like to take risks! This information will NOT be shared and is only kept on record for the youth year (August-July each year). Please contact Pastor Jordan with any questions! jdavis@kirkofkildaire.org
Youth Name *
Youth Birthday *
Youth Grade *
School (and if year-round, track) *
Youth Phone
Youth Email
Parent 1 Name *
Parent 1 Phone *
Parent 1 Email *
Parent 2 Name
Parent 2 Phone
Parent 2 Email
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