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Home
About
Bulletin Board
Cover Page
Feedback
PGBC
PGBC Cemetery
PGBC Documents
PGBC Staff
Our Ministries
Bible Study
Children's Ministry
Deacon Ministry
Education
Family Life
Ministry Teams
Missions
Music
Outreach
Pastoral
PGBC Recreational
Prayer Ministries
Senior Adults
Shoebox - 2024
Sunday School
Youth
Give
Watch Service
MMO Preschool
MMO
Infant's Gallery
One's Gallery
Two's Gallery
Three's Gallery
Four's Gallery
TK'S Gallery
MMO Documents
Feedback
Student's Name
*
First Name
Last Name
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Name
First Name
Last Name
Student's Phone #
*
(###)
###
####
Parent/Guardian Phone #
*
(###)
###
####
Parent/Guardian Phone #
(###)
###
####
Student's Email
*
Parent/Guardian Email
*
Parent/Guardian Email
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Birthdate
*
MM
DD
YYYY
School
*
Grade
*
6th
7th
8th
9th
10th
11th
12th
Track
*
Traditional
Track 1 Year-round
Track 2 Year-round
Track 3 Year-round
Track 4 Year-round
T-shirt Size
*
XS
S
M
L
XL
XXL
Allergies
*
Type "None" if there are no known allergies
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone #
*
(###)
###
####
Emergency Contact Alternate Phone #
(###)
###
####
Any other pertinent information I need to know
As the Parent/Guardian of the youth named in this document: (Please Check one)
*
I hereby give permission to Pleasant Grove Baptist Chruch to use my child's photographic likeness in related church publications and websites for any lawful purpose.
I do not give permission for my child's photographic likeness to be used by Pleasant Grove Baptist Church.
Please sign and date granting or declining permission for photographic use.
*
Thank you!
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