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Youth Ministry 2022-2023 Registration
*Please fill out this form to register your Youth for the 2022-2023 year. If you have questions, please contact Denelle Manley at
dmanley@wakeforestumc.org
. (One form per youth please).
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* Indicates required question
Email
*
Your email
Youth First Name
*
Your answer
Youth Last Name
*
Your answer
Youth Email
*
Your answer
Youth Phone Number
*
Your answer
Youth Birthdate
*
MM
/
DD
/
YYYY
Youth Grade for 2021-2022 School Year
*
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Required
Youth's School
*
Your answer
Mailing Address
*
Your answer
Parent/Guardian Names
*
Your answer
Parent Email Address
*
Your answer
Parent Phone Number (Where best to reach you during meetings)
*
Your answer
Do you (youth) have any allergies or medical concerns we should know about? (Please write below. If none, type N/A)
*
Your answer
Emergency Contact Information (Someone other than parent. Please include name, relation, and phone number).
*
Your answer
Is there anything you would like us to know about you, things you would like to learn more about, or ways we can pray for you? (Please feel free to contact us directly with these responses instead).
Your answer
Send me a copy of my responses.
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