Youth Ministry

Youth's Name *

First

Last

Youth's Email *

Youth's Phone

Registering for:

Middle School Group (6th-8th grades)
High School Group
Teen Faith in Action Leadership Council
Coming of Age

Preferred Name and Gender Pronoun

Youth's birthdate

grade and age

Please tell us about any special needs, allergies, medications, dietary restrictions, or anything else that would impact a youth's participation

What else woud you like us to know about you/your youth?

Custodial Situation

Living with sole parent/guardian (no other guardians)
Living with both parents/guardians
Parents/guardians live apart, joint custody
Parents/guardians live apart, one has sole custody
Other situation (please explain below)

Are there any custodial issues we should be aware of, or anyone NOT allowed to pick up the youth?

How Will Youth Get to the Congregation or other Youth Program sites?

Parents will be driving them
Carpooling with other family
Youth drives themselves/walks/rides the bus/bikes

Primary Parent/Guardian (will be the one to receive emails/messages about the RE program) *

First

Last

Email *

Phone

For Text Messages?

Address

Address Line 1

Address Line 2

City

State

Zip Code

Second Parent/Guardian/Caregiver *

First

Last

Phone

Third Parent/Guardian/Caregiver

First

Last

Phone

Emergency Contact *

First

Last

Phone

In the youth program, pictures are taken and used on the congregation's website, blog, and in print publications.

I give permission for my child's picture to be taken and used in publications

In the youth program, field trips are organized as carpools.

I have a valid drivers license and insurance and would be willing to drive youth
I give my permission for my youth to ride in the car of other adult drivers for field trips

In the youth program, there will be occassional chaperoned overnights at the congregation

I am able to pass a background check and would serve as an occassional chaperone for overnights
I give my permission for my youth to attend overnights at OUUC

In the youth program, we communicate directly with youth via text message, email, and social media

I give permission for my youth to receive group texts about youth group
I give permission for my youth to receive emails about youth group
I give permission for my youth to be contacted through social media platforms, including but not limited to Facebook and Instagram