AYhigh 2022-2023
Please fill out this form and click submit.
Student's Name
*
Student's Email
Student's Phone
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.
9th
10th
11th
12th
Gender
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Male
Female
Address
*
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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
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
Submit
Description
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