NGM Youth Service Registration
Welcome to the Next Generation Ministry - Greater Youth Experience!  Please register your Youth to attend services at Greater St. Stephen 5600 Read Blvd. The names collected in this form will be placed in our database for future attendance check-in. [If you would like to register additional youths, please submit a separate form for each.]

Senior Pastor, Dr. T. Delbert Robinson and First Lady, Elder Jasmine Robinson, thank you for choosing to worship with us!  You can always email us at youth@gssmin.org.
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Email *
Parent/Guardian's First Name *
Parent/Guardian's Last Name *
Contact Number *
Street Address *
City *
State *
Zip *
1. Youth First Name *
2. Youth Last Name *
Youth Membership Status *
3. Youth Birthdate *
4. Current School *
5. Current Grade *
6. Food Allergies (if any) *
7. For the safety of your child, the parent must either pick up their child or submit authorization for an approved alternate guardian. Please give us the name and cell number of any person(s) you authorize to pick up your child from Youth Church.

If you do not give permission for anyone except you to pick up your child, please state that in the space below. *
Please list any school, extracurricular, community or church activities of which your child is an active participant.
A copy of your responses will be emailed to the address you provided.
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