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Who Are You Form?
This information is confidential. In effort to comply better with Safe Sanctuary, we need a little more info.
Please include both parents information.
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* Indicates required question
Email
*
Your email
Youth Full Name
*
Your answer
Grade
*
Your answer
School You Attend
*
Your answer
Birthday (mm/dd/yyyy)
*
Your answer
Phone Number (Cell for Text Notifications)
*
Your answer
Name(s) of Legal Guardian
*
Your answer
Hobbies, Job or Extra Curricular Activities
Your answer
Allergies - Please Explain
*
Your answer
Parent 1 - Full Name
*
Your answer
Parent 1 - Phone Number
*
Your answer
Parent 1 - Email
*
Your answer
Parent 2 - Full Name
Your answer
Parent 2 - Phone Number
Your answer
Parent 2 - Email
Your answer
Parent Marital Status
*
Married
Divorced
Widowed
Other
Shared Custody of Child
Does your child have permission to ride home with another youth or your parent?
*
Yes, my child can ride with another parent outside of carpooling
No, my child cannot ride with another parent outside of carpooling
Yes, my child can ride with another youth that is not a sibling
No, my child may not ride with another youth
Photo Permission - These will mostly be group photos
*
Yes - You can post photos of my child
No - You CANNOT post photos of my child
Required
Anything the Youth Leader Should Know?
Your answer
Send me a copy of my responses.
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