YOUTH MINISTRY FORM
Youth Registration form Saints Constantine & Helen Greek Orthodox Church, DC
Pre K - 12th grade 2020/2021 School Year

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Student #1 First Name *
Student #1 Last Name *
Student #1 Birth Date *
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DD
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YYYY
Student #1 Baptismal Name *
Student #1 Name's Day *
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/
DD
Student #1 Grade *
Student #1 Interests *
Required
Child's/Children's phone number and email will only be used for sharing information related to church events and programming.
Student #1 - Phone Number *
Student #1 - Email Address *
Student #1 Please list here any concerns or information about your student, including allergies. *
Student #2 First Name
Student #2 Last Name
Student #2 Birth Date
MM
/
DD
/
YYYY
Student #2 Baptismal Name
Student #2 Name's Day
Student #2 Grade
Student #2 Interests
Student #2 - Phone Number
Student #2 - Email Address
Student #2 Please list here any concerns or information about your student, including allergies.
Student #3 First Name
Student #3 Last Name
Student #3 Birth Date
MM
/
DD
/
YYYY
Student #3 Baptismal Name
Student #3 Name's Day
Student #3 Grade
Student #3 Interests
Student #3 - Phone Number
Student #3 - Email Address
Student #3 Please list here any concerns or information about your student, including allergies.
Student #4 First Name
Student #4 Last Name
Student #4 Birth Date
MM
/
DD
/
YYYY
Student #4 Baptismal Name
Student #4 Name's Day
Student #4 Grade
Student #4 Interests
Student #4 - Phone Number
Student #4 - Email Address
Student #4 Please list here any concerns or information about your student, including allergies.
Student(s) Medical Plan *
Permission to seek medical treatment incase of injury or sickness *
Are you stewards in good standing? *
Parent 1 First Name *
Parent 1 Last Name *
Parent 1 Cell Phone Number *
Parent 1 Email Address *
Parent 2 First Name
Parent 2 Last Name
Parent 2 Cell Phone Number
Parent 2 Email Address
Permission from Parent(s) to Contact Students via email. *
Permission from Parent(s) to photograph student(s) at church events for use in church publications *
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