2022-23 Student/Parent Form

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Please take the time to fill out the following student/parent information form. This form will:

1. cover all our activities for the 2022-223 children/youth ministry year, overnight trips or retreats will require an additional short permission form

2. ensure that parents, children, and youth will receive information concerning our youth ministry programming

3. help our children/youth ministry workers keep our youth safe during on and off-campus event.

Child/Youth's Last Name *

Child/Youth's First Name *

Child/Youth's Middle Names *

Gender *

Age *

Birthday *

YYYY

School *

Grade *

Address *

City *

Zip Code *

Child/Youth's Cell #

Child/Youth's Email Address

Has your youth participated in a confirmation class.

( Youth Min only )

Yes

N/A

Do you want your youth to participate in a confirmation class if they have not? ( Youth Min Only ) *

Yes

N/A

Mother's Name *

Mother's Best Contact number *

Mother's E-mail Address

Fathers' Name *

Father's Best Contact Number *

Father's Email Address

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