'23-'24 High School Youth Registration

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So excited for this upcoming year of youth programming! Please fill out the registration below for the 2023-2024 school year.

Feel free to reach out to Samantha at samantha@peacelutheranlz.com with any questions!

Email *

Parent/Guardian's Name(s): *

Parent/Guardian Phone Number(s) *

Please provide all email addresses you would like receiving our twice monthly newsletter: *

Address *

Student's First and Last Name: *

Student's Preferred Name: *

Student's Cell Phone Number (if applicable): *

I give my permission to Peace Lutheran Church staff (Samantha) to text or contact my child via their cell phone. The high school youth text thread includes youth who have opted in as well as the youth director and an additional chaperone adult.

Texts most often include reminders of upcoming events. *

Yes

Student's Birthdate: *

YYYY

Student's Grade Level: *

12th Grade

11th Grade

10th Grade

9th Grade

Confirmand entering H.S.

Required

Please list any allergies/dietary restrictions your student has:

Is there anything else you would like me to know about your student? Are there any accommodations that can be made to help your student to participate in youth group?

I give my permission for my child(ren)'s photo(s) to appear on the Peace Lutheran Church social media pages and/or the church website: *

Yes

Send me a copy of my responses.

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