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Youth Registration Form
Christ Church in Short Hills, NJ
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* Indicates required question
What is the youth's full name? (First, Middle, and Last)
*
Your answer
Which program are you registering for?
*
Choose
Middle School Youth Group (grades 6-8)
High School Youth Group (grades 9-12)
Confirmation
Student's Birthday
*
MM
/
DD
/
YYYY
Student's Birth Place
*
Your answer
Baptism Date, Denomination, and Place
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Your answer
Grade in School (as of fall 2023)
*
Choose
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
School (as of fall 2023)
*
Your answer
Youth Mobile Number
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Your answer
Youth Email
*
Your answer
Home Address
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Your answer
Parent / Guardian Name(s)
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Your answer
Parent Mobile Number
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Your answer
Parent Email
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Your answer
I/we grant Christ Church in Short Hills permission to use photos of my child in publications including but not limited to our website, Facebook page, and local newspapers
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Yes
No
I/We do hereby authorize staff or representatives of Christ Church to seek emergency medical, dental, health or hospital Services for my child in the event of an emergency when I am unable to give such consent.
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Yes
No
For Confirmation Student's Only: Please type in the name of an adult "sponsor" (parent, grandparent, aunt, uncle, friend, etc) who will rotate through the class, helping to support your youth's Christian formation
Your answer
By typing my name in I am electronically submitting my signature on this registration form
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Your answer
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