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Amicis High School Youth Group Registration

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  Student/Parent Information
  
  First and Last Name of Student REQUIRED Please fill out this field. Please enter valid data.
  
  Grade entering this Fall REQUIRED Please fill out this field.
  
  T-Shirt Size (For Kickoff Event this September) REQUIRED Please fill out this field.
  
  First and Last Name of Mother REQUIRED Please fill out this field. Please enter valid data.
  
  Email Address of Mother REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number of Mother REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  First and Last Name of Father REQUIRED Please fill out this field. Please enter valid data.
  
  Email Address of Father REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number of Father REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Street Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Parents, interested in helping out? REQUIRED Youth Group Night Team (assist in making youth group safe) Chaperone/Support Team (Off-Campus events i.e. retreats, special events) Help run/lead games Set up/ Clean up for events Weekly meal for teens Prayer Team (Praying for our teens) Photography (taking pictures at events) Not interested at this time Please fill out this field.
  
  Donation
  
  We are requesting a $50 donation per teen participating in Amicis to offset some cost of food & supplies for our activities and events. If you would like to donate this amount, please submit this form and click the "Donate" button. Thank you for your support!
  
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Amicis High School Youth Group Registration

Student/Parent Information

Donation

We are requesting a $50 donation per teen participating in Amicis to offset some cost of food & supplies for our activities and events. If you would like to donate this amount, please submit this form and click the "Donate" button. Thank you for your support!