FM | HS Youth Group

* First Name

* Last Name

* Email

* Any allergy information we should be aware of?

* Can our staff administer over the counter medication to your child?

* Any medications that your child is taking that we should be aware of?

* Can we use pictures with your child(ren) on social media and/or in church publications, like the encounter and weekly?

* Parent/Guardian Name

* Parent/Guardian Phone #

* High School Graduation Year