Lock in Registration Form

Student's Name

Parent/Guardian Name(s)

Student Phone Number

Parent Phone Number

What grade is your student in? What grade is your student in? 7th 8th 9th 10th 11th 12th

Parent Email Address

How old is your student?

Have you filled out a medical release form with us this year? Have you filled out a medical release form with us this year? Yes No Unsure

If not, please download and fill out the form. It must be turned in before the event. If not, please download and fill out the form. It must be turned in before the event. Medical Release From

Emergency Contact Name

Emergency Contact Phone Number

Do you regularly attend church? Do you regularly attend church? Yes No

If so, where?