Youth (in Grades 6th through 12th) Registration Form (2022-2023)

Please fill out this form and click submit.
This registration form is for August 2022 through May 2023.

Thank you for registering your child (in grades 6-12).

PLEASE COMPLETE ONE FORM PER CHILD.

We need a separate registration form for each of child participating in St James' programs.

If your child is age 0 through 5th grade, please complete a children's form instead.

We also need at least one parent to complete a parent form.
 
 
 
Please select one option.
Family Connections
 
 
 
Membership
Please select one option.
Life Events
Please select one option.
 
 
Education
 
 
Please select one option.
Youth's Contact Information
 
 
 
 
 
 
 
 
Allergies
 
 
 
 
 
 
 
 
 
 
 
 
Important Information
 
 
 
 
 
 
 
 
Authorization and Consent of Parent (s) or Legal Guardian for Medical Treatment
I grant my authorization and consent for St James’ Episcopal Church staff to administer general first aid treatment of any minor injuries or illnesses experienced by the Minor. I understand in an emergency situation, emergency services will be contacted.
Please select all that apply.
Media Release
I understand that photos or videos or audio of my child may be taken during family ministries activities and/or other church events. I consent to the use of my child's photo, voice, or likeness in promotional materials such as the church website, newsletter, brochures, bulletin, and social media outlets. I understand that my child's identifying information will not be provided unless I give permission at a later time.
Please select all that apply.
Parent/Guardian digital signature
 
 

Description

Please fill out this form and click submit.