2022-2023 Youth on Wednesday Night Registration  Form
YOW Registration Form and Permission Slip
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Name of Youth
Birth date of youth
MM
/
DD
/
YYYY
Grade of Youth in Fall 2022
Clear selection
Name of School
Name of Parent or Guardian
Phone/Cell Number
Parent/Guardian Email Address
Youth Email Address
Home Address (Number and Street)
City, State, Zip
Is your youth a new or returning student
Clear selection
Do you prefer virtual or in-person lessons
Clear selection
As the parent or guardian of the person listed above, I give permission for my child to attend, be transported to and from preconfirmation/confirmation and youth program events including service projects, and youth night activities, and participate in activities related to these events. In the event that my child may require medical attention, I expect that reasonable efforts will be made to contact me; however, permission is granted for the leaders of the event to seek emergency medical attention for my child. I also understand that participation in any Confirmation program or activity is a privilege. If for any reason my child violates that privilege, I agree to come or make the necessary arrangements for my child to be picked up. IF YOU AGREE, PLEASE TYPE YOUR NAME and today's date below.
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