St. Francis Youth Group Registration
For School Year 2021/2022 (6th - 12th grade).

Please submit this form for each youth participating in Youth Group this year.
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Email *
Student's Name/Nickname/Preferred Name   *
Birth Date (including birth year) *
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Age *
Grade and Name of School This Fall
Student email
Student cell #
Do you text? y/n
Clear selection
What is the best way to get in touch with you?
Mailing Address (including city and zip)
Tell us about you! What are your special gifts, talents, or interests?
Parent/Guardian #1 Name and email *
Parent/Guardian #1 phone (please indicate if home or cell) *
Parent/Guardian #2 Name and email
Parent/Guardian #2 home phone (please indicate if home or cell)
From time to time we will need parent chaperones for outings or special events.  Would you be able to help out?
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I give permission and consent for photographs or video footage of my student to be published and used by St Francis Church to illustrate and promote St. Francis Church and/or its ministries. For the safety and security of your student, we will never print your student’s name with his/her photo or video. *
What special Youth Group activities interest you? *
Required
Do you any ideas or requests for Youth Group?
What would inspire you to invite a friend to church?
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