H2H Registration 2022-2023
Please fill out this form and click submit.
Student's Name
*
First Parent Name
*
First Parent Email
*
This address will receive a confirmation email
First Parent Phone
*
First Parent Volunteer Interest
Please select all that apply.
Small Group Leader
Substitute Small Group Leader
Youth Event Helper (driver, chaperone, snacks, etc.)
Second Parent Name
Second Parent Email
Second Parent Phone
Second Parent Volunteer Interest
Please select all that apply.
Small Group Leader
Substitute
Youth Event Helper (driver, chaperone, snacks, etc.)
Grade
*
Please select one option.
6th
7th
8th
Gender
*
Please select one option.
Male
Female
Address
*
--
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Payment
40.00
As the parent or legal guardian, I give consent for my youth to participate in all the scheduled youth activities of Alleluia! Lutheran Church and any other supervised activities customarily associated with its youth group including, but not limited to, off site youth events and overnight or weekend youth retreats. Further, I certify that my youth is able to participate in all activities. If there are special circumstances or I wish to revoke this consent for any reason, I will promptly notify the leader of Alleluia!'s youth program in writing. Also, I understand that my child may be photographed while participating in youth activities and that these images may be used by Alleluia! in their physical and digital publications, including online sources.
*
Please select all that apply.
I agree
Credit/Debit Card Number
Expiration Date/CVC
Name on Card
Card Billing Address
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Submit
Description
Please fill out this form and click submit.
×
Please Fix the Following