Youth Email

Youth Phone Number

Adult Caregiver

Adult Caregiver

Extra Email

Extra Phone

Emergency Contact

I am registering for.... (chose all that apply for this student)

Sunday School (Middle School)Sunday School (High School)Appalachia Service Project (High School)PuppetsRevelation RingersFirst Friday Youth Group (Middle School)First Friday Youth Group (High School)Rainbow AllyanceYouth Praise BandWednesday WalkCrucifer (High School)Acolyte (Middle School)

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