District Celebrate Life 18 Student Registration
January 26-27, 2018 ~ Kuyper College Cost will be different for each church based on transportation and hotel costs. Please contact your youth pastor/leader for the amount. Regardless of the base amount, you will need to add $1 for each event your student is participating in.

There are 5 sections to this registration form and it should take about 5-10 minutes to fill out.

PLEASE SUBMIT ONE FORM FOR EACH STUDENT (even if from the same family).

Lastly, you will receive a copy of your answers via the email address you provide. PLEASE FORWARD THAT EMAIL ONTO YOUR YOUTH PASTOR/LEADER so they know you are registered. Thank you!

Email address *
Student Name (First and Last) *
Your answer
Gender *
Date of Birth (dd/mm/yyyy) *
Your answer
Grade *
Address *
Your answer
City, State, Zip Code *
Your answer
Phone Number *
Your answer
Alternative Phone Number *
Your answer
Local Church *
Adult Sponsor (adult responsible for you during District Celebrate Life) *
Your answer
T-shirt Size *
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