JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Youth Group Registration 2023-2024
Sundays 5:30 - 7:30 (see schedule for details)
All teens grades 6 - 12 are welcome.
Leominster United Methodist Church
77 Hall St.
Leominster, MA 01453
(978) 537-1356
lumcoffice1@gmail.com
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Child's Name
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Parent / Guardian #1 Name
*
Your answer
Parent / Guardian #2 Name
Your answer
Contact Phone Number(s)
*
Your answer
Contact Email(s)
*
Your answer
Contact Phone Number(s)
*
Your answer
Child's Home Address
*
Your answer
Any allergies or dietary restrictions?
Your answer
Any medical conditions we should know about?
Your answer
Any special accommodations needed?
Your answer
Anything else we should know to help make your child's youth group experience a positive one?
Your answer
Do we have permission to transport your child in the case of an emergency?
*
Yes
No
Do we have your permission to transport your child in a vehicle for official youth group activities?
*
Yes
No
Required
Do we have your permission to publish images of your child in church publications such as the church website, newsletter, and on social media?
*
Yes
No
I give permission for the following person(s) to pick up my child from official youth group programs:
Your answer
I acknowledge that I have received a copy of the church's Safe Sanctuary policy.
Safe Sanctuary Policy
*
Yes
Required
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
