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Velocity 2021 Youth Info
Please fill out the form so our youth group can better serve you!
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* Indicates required question
Last Name
*
Your answer
First Name
*
Your answer
Address
*
Your answer
State
*
Choose
OH
City
*
Your answer
Zip Code
*
Your answer
School
*
Your answer
Birthday
*
MM
/
DD
/
YYYY
Age
*
Choose
12
13
14
15
16
17
18
Grade
Choose
7
8
9
10
11
12
Email
Your answer
Student Cell Number
Your answer
Do you want to be notified of upcoming youth events?
*
Yes
No
Maybe
Do you want to be added to the youth group texting thread?
*
Yes
No
Parent/Guardian Name(s)
*
Your answer
Parent/Guardian Phone Number
*
Your answer
Do you have any allergies?
Your answer
What is/are your preferred social media platforms?
*
Facebook
Instagram
Tik Tok
Snapchat
Youtube
Other
I'm not on social media
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