Calvary High School Youth Registration

Student Name Student Name * First Last
Student Grade *

Student Grade 9th-Freshman 10th-Sophmore 11th-Junior 12th-Senior
Student Phone Student Phone * - ### - ### ####
Student Email *
Parent/Guardian Cell Phone 1 Parent/Guardian Cell Phone 1 * - ### - ### ####
Parent/Guardian Cell Phone 2 Parent/Guardian Cell Phone 2 - ### - ### ####
Parent/Guardian Email *
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
I have permission to participate in any activity planned for the Calvary Lutheran Education Program. I agree that the church, its personnel and volunteers and teachers will not be held responsible and hereby release them from any accidents which may occur.

Photo Release: I hereby grant permission to Calvary Lutheran to use photographs and/or video of me in publications, news releases, online, and in other communications related to Calvary's mission.

THIS IS A RELEASE. I HAVE READ AND UNDERSTAND THIS RELEASE. *

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
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