Home
About
Leadership
Contact
History
Connect
Youth
Prayer Request
Rental Space
Media
Give
I'm New
Youth Ministry
UPCOMING EVENTS
PARENTS NIGHT OUT
Registration
First Name
Last Name
Email
Number Of Children?
One
Two
Three
Child Name:
Child Age:
Child 2 Name:
Child 2 Age:
Child 3 Name:
Child 3 Age:
Home Address:
City/State:
Zip Code:
Home/Cell Phone #
Emergency Contact Name & Phone #
Child's Physician's Name:
Any Medical concerns that we should be aware:
Allergies/Dietary Restrictions
I authorize medical treatment for my child in case of an accident or illness if the parent or guardian cannot be located and an emergency situation arises
I Agree
I Do Not Agree
Do you authorize any other adults to pick up your child? If yes, Please list them below:
<
Back
Next
>
Submit
Pay Registration Fee Below
$10 per child
Sunday School
9:30am-10:30am
Contact Us
We'd love to hear from you. If you have any questions about our youth program
Please email youthleader@hamptonsumc.org
