High School Youth Group Registration

Your Name (the person filling out this form) (required)

Your Email (required)

Name(s) of Parent/Guardians (please separate each name with a semicolon)

Email Addresses of Parent/Guardians (please separate each address with a semicolon)

Cell Phone Numbers of Parent/Guardians (please separate each number with a semicolon)

PLEASE FILL OUT ONE TEXT AREA FOR EACH TEEN REGISTERING FOR YOUTH GROUP:

Name, grade level, and birth date of Teen (Please use first and last names)

Name, grade level, birth date, and email of Teen (Please use first and last names)

Name, grade level, birth date, and email of Teen (Please use first and last names)

Name, grade level, birth date, and email of Teen (Please use first and last names)

Name, grade level, birth date, and email of Teen (Please use first and last names)

Name, grade level, birth date, and email of Teen (Please use first and last names)

Is there any additional information that we should know?