Life Teen Registration
Please use this form to register for our High School Ministries during the 2020-2021 academic year.
We ask that you submit separate registration forms per student.

PLEASE MAKE SURE THAT ALL INFORMATION ENTERED IS ACCURATE AND UP TO DATE. ALL OF OUR COMMUNICATION DURING THE YEAR WILL BE BASED ON ADDRESSES AND NUMBERS THAT YOU SUPPLY US. IF ANY OF THE INFORMATION ENTERED IN THIS FORM WERE TO CHANGE DURING THE YEAR, PLEASE INFORM US AS SOON AS YOU ARE ABLE SO WE MAY UPDATE OUR RECORDS.

DO NOT Use this form to register teens for the Confirmation Process!
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Email *
Student Information
Last Name *
First Name *
Date of Birth *
MM
/
DD
/
YYYY
Gender *
School *
Grade *
Fall of 2020
Student Email *
Student Cell Number
Which High School Ministries would you like your teen to be included in from the beginning of the year? (Select all that apply) *
Required
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