HCC JR. & SR. YOUTH REGISTRATION

YOUTH INFO

Youth's Full Name

Date of Birth

Youth's Phone Number

Please leave blank if your child does not have their own phone.

Youth's Email Address

This address will receive a confirmation email

PARENT/GUARDIAN INFO

Parent/Guardian Full Name

Best Phone Number

This address will receive a confirmation email

How would you prefer us to contact you about youth events and info?

Text Email Call Facebook Page Any of the above

Is there another parent/guardian who should also receive youth communication?

Yes No

If yes:

Parent/Guardian Full Name

Phone

This address will receive a confirmation email

EMERGENCY CONTACT

Emergency Contact Name

Relationship to Youth

Emergency Contact Phone

Does your child have any allergies, medical conditions, medications, or other health information our youth leaders should be aware of?

Yes No

If yes:

Please provide any relevant medical information

Is there anything else our youth leaders should know to help us safely and appropriately care for your child?

PICKUP & DEPARTURE

How will your child normally leave youth activities?

Are there any custody, pickup, or other restrictions regarding who may pick up or have contact with your child that our youth leaders need to know about?

Yes No

If yes:

Please Explain

PERMISSIONS

Emergency Medical Care Permission

I give permission for HCC youth leaders to seek appropriate medical attention for my child in the event of an emergency. Every reasonable effort will be made to contact me or my emergency contact as soon as possible.

Yes No

Transportation Permission

I give permission for my child to be transported by approved Hillside Community Church leaders or volunteers for church-related youth activities and events.

Yes No

Photo & Video Permission

I give permission for photos or videos of my child to be used by Hillside Community Church for our church website, church Facebook page, and church-related advertising

Yes No

HCC JR. & SR. YOUTH REGISTRATION - 2026/2027

Description

HCC JR. & SR. YOUTH REGISTRATION - 2026/2027

Description

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