GEMS @ New Street CRC Registration 2019-2020

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We are excited to be able to start our GEMs girls group again. This year we are offering our program to girls in grades 2 up to grade 8. Grade 8 students have the choice of attending GEMs or FROGS.
We have a few things planned, but first we need you to fill out this form for each student attending youth group in your family. Please have this done by Thursday September 19th. All info will be kept private & confidential.

Email *

Participant's Information

First Name (full) *

Last Name *

Likes to be called (if different than above);

Home address- including city & Postal code *

Birth Date:

YYYY

Participant's Parent/Guardians name (mother if applicable): *

Participant's Parent/Guardians name (father if applicable):

Is there a custody arrangement or order we need to be aware of?

Yes

We will discuss with you

Clear selection

Home landline #

Mother's cell phone: *

Father's cell phone

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