Route 78 Registration  2023-2024
Route 78 is the learning opportunity for middle school students (grades 7 & 8). We will first be meeting October 6th at 7pm as a kick-off/get to know me event to brainstorm together what confirmation can look like for us--We will not be meeting weekly and I’m trying to get a feel for what not only this community is interested in, but what this community is excited to do! Overall, I want to get to know you and build relationships with you all. And that’s going to take time! I’m trying to have us figure out together what that relationship building will look like. Friends are welcome.

Please complete a separate registration form for each child.  Thank you!
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Child's Name *
Grade in school during 2023-2024 school year *
Birth Date *
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Student Cell Phone
Student Email  
Name of Parent(s) *
Parent Email Address *
Parent Cell Phone *
Home/Mailing Address *
Please list allergies:
Health Concerns/Special Instructions *
I authorize my child to participate in all Route 78 related activities. *
I authorize my child to ride in a vehicle driven by an approved and licensed ADULT chaperone while participating in Route 78 activities. *
My child's photo can be used on Peace's website and Facebook page.                                        (Please note that photos of kids will be taken during youth activities, but if you answer "no", the pics will not be used for promotional purposes.)   *
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