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Youth Ministry
UPCOMING EVENTS
When: Second Fridays of Every Month
TIME: 6-9pm
Where: Hamptons UMC
160 Main Street, Southampton
Ages: 5-10
Registration fee: $10
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:
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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
