Middle School Summer Stretch 2025

Please fill out this form and click submit. Thank you for registering your youth for summer stretch 2025.

Youth Name

Parent/Guardian Name(s)

Parent's Email

This address will receive a confirmation email

Address

Parent/Guardian Cell Phone

Name of parent/guardian 1:

Parent/Guardian Cell Phone 2

Name of second parent/guardian:

Grade youth completed 2024-2025

Please select all that apply.

5th 6th 7th 8th 9th

Youth's t-shirt size

Please select all that apply.

Adult Small Adult Medium Adult Large Adult XL Adult XXL Adult XXXL

Dates I Plan on Attending

Please select all that apply.

June 5 June 12 June 19 June 26 July 1 (Tuesday) July 10 (Twins Game)

Allergies:

We need parents to help volunteer, as our ministry has grown so has our need for more volunteers and transportation. Dates I would be willing to help drive & volunteer

Please select all that apply.

June 5 June 12 June 19 June 26 July 1 (Tuesday)

Number of youth I could help transport in my vehicle

Health Insurance Company

Health Insurance Company Phone

Health Insurance Policy Number

Health Insurance Policy Holder's Email

If parent/guardian(s) cannot be reached please contact:

Emergency Contact's Phone:

Payment

Pay Online Now ($100.00) Drop $100 off in the office ($0)

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

Please fill out this form and click submit. Thank you for registering your youth for summer stretch 2025.

Middle School Summer Stretch 2025

Description

Please Fix the Following