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Youth Ministry Registration Form
Matthew Ricks
2023-05-17T20:08:07-06:00
Please enable JavaScript in your browser to complete this form.
Youth name
*
First
Last
Legal guardian names
*
Legal guardian email
*
Address
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Legal guardian phone
*
Youth cell phone
This is so the church can communicate with your child.
May SCCC use photos of your child?
*
Yes
No
Youth insurance information
*
Group, ID, Insurance company, and doctor.
If we cannot reach you, does SCCC have permission to obtain medical treatment for your child?
*
Yes
No
If it is deemed medically urgent, care will be ultimately provided.
Does SCCC have permission to take your child/youth on activities and trips?
*
Yes
No
We cannot take your child anywhere without your permission. Thanks.
May your child walk to church for youth group?
*
Yes
No
Does your child have any food allergies? If so, what are they?
Do you understand that youth group is from 6:30-7:30 and kids will not be watched after that?
*
Yes
No
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