ELCA Youth Gathering 2022 Registration


	  	 First Name  *
Last Name  *
Date of Birth 
Current Grade  *8th Grade9th Grade10th Grade11th Grade12th Grade
Age at time of Gathering  *
T-Shirt Size  *
Parent/Guardian's First Name  *
Parent/Guardian's Last Name  *
Second Parent/Guardian's First Name 
Second Parent/Guardian's Last Name 
Address  *
City/State  *
Zip  *
Parent Phone Number  *
Second Parent Phone Number 
Youth's Phone Number  *
Parent's Email  *
Youth's Email  *
 I am willing to help with preparing for the trip (including filling out lots of forms) to the best of my ability.
 I am willing to commit to attending preparation meetings to the best of my ability
Signature of Parent/Guardian  *
Signature of Youth  *
Date  *
 
Verification
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