Zone 5th & 6th Preteen Student Info

Who’s this registration for?

First name

Last name

Email address

Date Of Birth

Gender

Male Female

Grade (2023-24)

5th 6th

School

Home Address

Parent/Guardian #1 First & Last Name

Parent/Guardian #1 Phone Number

Parent/Guardian #1 Email

Parent/Guardian #2 First and Last Name

Parent/Guardian #2 Phone Number

Parent/Guardian #2 Email

Would You Like to Receive our Weekly Zone Email with Ministry Updates?

Yes No

If yes, which email would you like it sent to?

Would you like to chaperone events?

Things to Make Us Aware Of? (allergies, needs, etc.)

Would you like to volunteer on Sunday or Wednesday Services?

First & Last Name

Grade (2023-24)

Gender

Address

School

Parent/Guardian

Emergency Contact #1 First & Last Name

Emergency Contact #1 Cell

Emergency #2 First & Last Name

Emergency Contact #2 Cell

Things to Make Us Aware Of? (allergies, needs, etc.)