MPC Youth Participation Form '23-24
This form is required for all participants in MPC Youth Ministry programs and events.

For email below, please put your Family Email or whatever email youth ministry info and updates should be sent to. (If you have more than one email that should receive these messages, please complete the below)
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Email *
Additional Email(s) (student, second parent/guardian)
Student Information
First Name *
Last Name *
Preferred Name (if different)
Pronouns *
Date of birth *
MM
/
DD
/
YYYY
Student's Cell Phone (if they have one)
Student's Shirt Size (in adult sizes)
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New here? Welcome! How did you hear about us or who invited you? (if applicable)
Grade starting in the fall (for 2022-2023 school year) *
School Attending *
Home Address *
Home Church (if other than MPC)
Parent/Guardian 1 Name *
Parent/Guardian 1 Cell Phone Number *
Parent/Guardian 2 Name
P/G 2 Cell Phone Number
Parent/Guardian 3 or other Emergency Contact Name (Different than P/G 1 and 2 please) *
Parent/Guardian 3 or other Emergency Contact Phone Number *
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