Youth Group
IHA Youth Group Sign Up
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Name of Child *
Name of Parent *
Phone Number *
Email Address *
Current Discipline Rode *
Required
Are you an IHA Member? (If no you must join prior to attending youth group events) *
If your child is under 8 years old, you must stay at IHA events & meetings with them or provide a guardian.
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By Completing this form, I acknowledge and agree that I hereby release IHA and Suffolk County or any of their agents for any injury or loss suffered during this event or in connection with this event. Photographs taken at an IHA Sponsored event may be used in publication. Please type your name below as acceptance. *
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