Middle School Youth Registration Form

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Middle School Youth Registration Form

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* Indicates required question

Student's First Name *

Your answer

Student's Last Name *

Your answer

Gender *

Male

Female

Grade *

Grade 6

Grade 7

Grade 8

School in Attendance *

Your answer

Student's Email Address

Your answer

Student's Phone Number

Your answer

Parent Contact Name (First and Last) *

Your answer

Parent Contact Cell Phone Number *

Your answer

Parent Contact Email Address *

Your answer

Home Phone Number *

Your answer

ZOOM Contact Email Address *

Your answer

Church Home Campus *

Which Church Campus do you most regularly attend?

Downes Road Campus

East Abbotsford Campus

Mission Campus

I Attend a Different Church

I Don't Attend Church

Student Medical Notes

Your answer

Submit

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This form was created inside of Northview Community Church. Report Abuse