Confirmation & Senior High Registration
Text Phone Number
Emergency Contact Phone #
Check all that your youth will be participating in:
Youth Group 9-12
Appalachian Service Project registration is separate from this form. Please go to the ASP link
Medical or other information we should be aware of:
Please email me monthly newsletter:
I agree to allow my child's photograph to be taken and used for church only promotional materials such as bulletin boards and display cases, brochures, web, PR, etc. I understand that the church will not sell or give my child's picture to any other organization.
Success! This form has been submitted.