Student Ministry Lift Tour

I. Student Information
Student's Name*
First Last
Student's Address*
Street Address City State ZIP Code
Student's Cell Phone*
Student's Email*
Student's Date of Birth*
Student's Grade*
Student's T-shirt Size*
II. Parent's Information
Parent's Name*
First Last
Parent's Cell Phone*
Parent's Email*
Transportation*
- I can drive students to the event.
- My student will need transportation.
If you can assist with transportation, how many spaces are available in your vehicle (not counting the driver).
Overnight Host*
- Yes, I/we can host students in my/our home on Friday night.
- No, I/we cannot host students overnight.
III. Parent Agreement
Agreement*
Please check each box as your agreement to the following statements.
- I understand that my student will not be permitted to attend without completing the 2018-2019 Medical Info & Release Form
- I understand that my child's registration is not official until I pay the $40 event fee.
Parent's Electronic Signature*
Please type your name below as your signature to the above Parent Agreement statements.
Phone
This field is for validation purposes and should be left unchanged.

I. Student Information