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Youth Ministry Registration Form (6th - 12th Grade)
Youth's First Name
Name Goes By
Youth's Last Name
List any known allergies / food allergies your youth may have:
List any medical conditions or physical limitations your youth may have:
Youth's Phone #
Youth's Email Address
Mother/Guardian Phone #
Father/Guardian Phone #
Are there any learning or educational concerns that would help us serve your youth better?
My youth has permission to attend Wednesday Night BREAKOUT.
I give permission for the youth leaders to contact my youth by phone, text, or email.
I give permission for my youth to be photographed for possible use in church media and printed materials.
Please do not photograph my youth
By typing your name you are electronically signing this form.
Something for Everyone
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