Christian Youth Education Registration

Parent/Guardian Name
First Last
New or Returning*
If you are registering your child for the 1st time, welcome! Please complete all the information on this form. If your child has previously attended Youth Education, welcome back! You only need to update any information that has changed such as phone numbers, emails, allergies or special needs.
- NEW to Youth Education at New Life
- RETURNING to Youth Education (Complete below only if changes)
Child(ren) Information
Add additional children, click the + sign on the right side.
First & Last Name Birthdate School grade this fall
Address
Street Address Address Line 2 City ZIP Code
Email
Phone
Allergies or special needs information
Consent
I give permission to have my child photographed or filmed as participating in New Life's activities for any lawful purpose.
How did you hear about our Youth Education program?
- Attend New Life
- Website
- Facebook
- Friends at New Life
- Community group that meets at New Life
- Other

First & Last Name	Birthdate	School grade this fall