Youth Quest Student Registration

Use this form to register for Youth Quest Summer 2019. 
*Starred items are required. 
Your registration is complete when you click the 'SUBMIT MY REGISTRATION' button below and see the word SUCCESS!

Student Section
Any Allergies or Medical Concerns? *
Family Information
Primary Phone # *
Primary Phone #
Secondary Phone
Secondary Phone
Home Church
Emergency Contact Information
Emergency Contact Phone Number *
Emergency Contact Phone Number
Parental Authorizations
I permit my child to drive themselves to and from Youth Quest *
By checking this box, I acknowledge that I am the parent/guardian, and agree to the above transportation arrangements