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Youth Info Sheets (Fall 2022)
This form is for collecting information on our Students (& Parents) for the purpose of keeping in regular contact about upcoming events & discipleship opportunities for Erieside Youth Students throughout the year!
Parent/Primary Contact Info:
Primary Contact Name
(Required)
First
Last
Primary Contact Phone
(Required)
Primary Contact Email
(Required)
Best Means of Contact
(Required)
Text
Email
Either is fine
Address
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Secondary Contact Name
(Required)
First
Last
Secondary Contact Phone
(Required)
Secondary Contact Email
(Required)
How many 6th-12th Grade Students do you have?
(Required)
Please enter a number from
1
to
3
.
Student 1 Info:
You decide whether it's based on age or whether they're your favorite--we won't tell...
Student Name
(Required)
First
Last
Student Phone
(Required)
Student Birthdate
(Required)
MM slash DD slash YYYY
Student Email
(Required)
Student School
(Required)
Student Grade
(Required)
Please enter a number from
6
to
13
.
Any Food/Other Allergies?
(Required)
I am ok with Youth Leaders Contacting my Student outside the context of regular Bible Studies/Events.
(Required)
Yes
No
Only same-gendered Leaders
I am ok with my Student having an Adult Mentor.
(Required)
Yes
No
Please contact me first
I am ok with my Student being photographed at Events & during Bible Study.
(Required)
Yes
No
Only internal use (No social media)
Student's favorite Candy/Snack
Student's favorite Band
Where is your Student most gifted (in your opinion)?
Where does your student need growth in their walk with the Lord?
Anything else we should know about your Student?
Student 2 Info:
Student Name
First
Last
Student Phone
Student Birthdate
MM slash DD slash YYYY
Student Email
Student School
Student Grade
Please enter a number from
6
to
13
.
Any Food/Other Allergies?
I am ok with Youth Leaders Contacting my Student outside the context of regular Bible Studies/Events.
Yes
No
Only same-gendered Leaders
I am ok with my Student being photographed at Events & during Bible Study.
Yes
No
Only internal use (No social media)
I am ok with my Student having an Adult Mentor.
Yes
No
Please contact me first
Student's favorite Candy/Snack
Student's favorite Band
Where is your Student most gifted (in your opinion)?
Where does your student need growth in their walk with the Lord?
Anything else we should know about your Student?
Student 3 Info:
Student Name
First
Last
Student Phone
Student Birthdate
MM slash DD slash YYYY
Student Email
Student School
Student Grade
Please enter a number from
6
to
13
.
Any Food/Other Allergies?
I am ok with Youth Leaders Contacting my Student outside the context of regular Bible Studies/Events.
Yes
No
Only same-gendered Leaders
I am ok with my Student being photographed at Events & during Bible Study.
Yes
No
Only internal use (No social media)
I am ok with my Student having an Adult Mentor.
Yes
No
Please contact me first
Student's favorite Candy/Snack
Student's favorite Band
Where is your Student most gifted (in your opinion)?
Where does your student need growth in their walk with the Lord?
Anything else we should know about your Student?
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