Contact information
TBC Youth ALIVE (Middle School/High School) - Please complete this form.  This information will be used for ministry purposes.   Thank You 
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Name *
Date of Birth (Month, Day, Year) *
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DD
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YYYY
Enter Current School Grade (6th - 12th) *
Enter Current  Middle School/High School Your Child Attends *
Email *
Address *
Phone number *
Parents Name  *
Parent's Cell Number (XXX-XXX-XXXX) *
Parent's email.  *
Do you authorize and consent to the use of pictures or videos of you and your child, with or without your name, by Tabernacle Baptist Church located at 519 W 19th Ave, Gastonia NC 28052 for purposes including but not limited to: ministry promotional materials, printed publications, internet posts including social media, television, and other media sources?  Do you release Tabernacle Baptist Church, its officers, trustees, employees, and agents from liability for any claims by you or any third party in connection with the use of the image of you and/or your child?
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