Youth Group Registration Form

Youth Name

Nickname

Date of birth:

Age as of September 2024:

Grade in September 2024

School

Names of Parents/Guardians:

Address Line 1:

Address Line 2:

City:

State:

Zip code:

Home Phone Number:

Parent Email Address:

Parent/Guardian Name and Cell h

Parent/Guardian Name and Cell Phone:

Are you new to Christ Church?

If yes, I would like a parent or member of the clergy to call me

Yes

Please list any allergies your child has:

My child is interested in serving as an acolyte, greeter or lay reader (please list)

My child is interested in singing with the choir:

Yes

I am able to help with meals/transportation/other

I give permission for this child to have his/her photo used (without name( on the Christ Church website, e-Prophet or other newsletters.

I give permission for medical treatment for this child in case of accident or illness if a parent or guardian cannot be located or an emergency should arise

33 Central St., Andover, MA 01810 | 978-475-0529

Everyone is Welcome at God's Table

Youth Group Registration Form

Youth Group Registration Form

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