Stand Youth Event Registration

Student Name *
Student Name
Student Phone *
Student Phone
Please enter parent/guardian phone number if student does not have one.
Address *
Address
When is your birthday?
When is your birthday?
Please enter a name if someone personally invited you.
Emergency Contact *
Emergency Contact
Phone *
Phone
Permission Release *
By checking the box below, I, the parent or legal guardian of the registrant named above, give permission for my child to attend the Stand Youth Event, hosted by Resurrection Life Church - Cadillac, and to fully participate in all aspects of the conference. I will not hold Resurrection Life Church - Cadillac responsible in case of injury or illness. I give permission for trained medical personnel to provide routine medical care and/or emergency medical treatment and I authorize Resurrection Life Church - Cadillac to sign consent forms for such treatment.