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2019 College Ready Registration March 23rd
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Indicates required field
Student's Name
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First
Last
Grade Child Will Be In Aug. 2019
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9th Grade
10th Grade
11th Grade
12th Grade
College Freshman
Parent/Guardian Name
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Cell Phone Number
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Address
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City
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State
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Zip Code
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Parent/Guardian Email
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Student's Food Allergies
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Emergency Contact Name
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Emergency Contact Phone #
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Emergency Contact Relationship to Child
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Other Allergies or Medical Conditions
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May we have permission to photograph and/or video your student for use in church publications?
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Yes, you have permission to photograph/video my student.
No, I do not give permission to photograph/video my student.
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