HYPE Student Information Form

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Hope Community Church Youth Group
When: Held every 1st and 3rd Sunday of the month (unless otherwise noted)
Time: 6pm-8pm
Where: Held at The Field Residence (unless otherwise noted): 2 Two Penny Run W, Pilesgrove, NJ
For Updates and Information please join us on REMIND by texting @4afh77 to 81010

Student First and Last Name *

Student Date of Birth *

JJJJ

School currently attending and Grade *

Student Cell Phone Number *

Parent/Guardian First and Last Name *

Parent/Guardian Email *

Parent Phone Number *

Address *

Emergency Contact Name and Number *

I give permission for photos, that my child may be in, to be used on the church website, social media or video presentations. *

Yes

Allergies *

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