ALL-YOUTH SERVE & HOUSE PARTY
Saturday, June 15
*Register by Thursday, June 12
Student First Name
Student Last Name
Student Cell Phone (optional)
Parent/Guardian Cell Numbers(s)
Emergency Contact Name and Cell:
Additional Information (i.e. allergies, meds, event specifics)
Parental/Guardian Agreement: "By submitting this Registration Form I AGREE that I have given permission for my student to be at the specific youth event for the designated times, under the supervision of the event leaders."
Yes, I agree
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