HRC Youth Group - Register Student

2026-2027 HRC Youth Group Registration

Register any time between September 1st 2026 and August 31st 2027

HRC Youth Group Registration

Parent First Name

Parent Last Name

Parent Email

Parent Number

Student's First Name

Student's Last Name

Student's Email

Student's Phone Number

Student's Birthdate

Student's Gender

Student's Grade

Student's Allergies

Student's School

Student's Extracurricular Activities (Sports, Drama, etc)

List all students Likes and Interests

Emergency Contact Details- Name, Number and Relationship to student in the case of emergency

Are you ok with your child being on Hopewell Reformed Church Social media pages?

Yes

What do you hope this student will get out of Hopewell Reformed Church's Youth Group program?

List anything else that would be helpful to know about this student?

Is This Student in 10th, 11th, or 12th Grade?

Yes

Does This Student Know What they Want to Do After High School? If so, please describe. (Go to College, work, Army desired major, any college preferences)

Is this Aligned with what you would like them to do? (If No, please explain)

Are there any skills the student has that would set them apart from their peers? (If yes, please explain)

Are there any concerns you have for this student? Anything you would like them to work on?

Do you have another student to register?

Yes

Student's First Name

Student's Last Name

Student's Email

Student's Phone Number

Student's Birthdate

Student's Gender

Student's Grade

Student's Allergies

Student's School

Student's Extracurricular Activities (Sports, Drama, etc)

List all students Likes and Interests

Emergency Contact Details- Name, Number and Relationship to student in the case of emergency

Are you ok with your child being on Hopewell Reformed Church Social media pages?

Yes

What do you hope this student will get out of Hopewell Reformed Church's Youth Group program?

List anything else that would be helpful to know about this student?

Do you have a 3rd student to register?

Yes

Student's First Name

Student's Last Name

Student's Email

Student's Phone Number

Student's Birthdate

Student's Gender

Student's Grade

Student's Allergies

Student's School

Student's Extracurricular Activities (Sports, Drama, etc)

List all students Likes and Interests

Emergency Contact Details- Name, Number and Relationship to student in the case of emergency

Are you ok with your child being on Hopewell Reformed Church Social media pages?

Yes

What do you hope this student will get out of Hopewell Reformed Church's Youth Group program?

List anything else that would be helpful to know about this student?

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