HIGHLAND CHRISTIAN CHURCH
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Youth/Young Adult Groups
Ignite Registration
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Address
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Current school
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Email
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Phone Number
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How to contact you:
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Phone (cell or home)
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Parent
Do you attend church? Where?
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Grade currently in
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Mother's Name
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Mother's Phone
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Father's Name
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Mother's Email
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Father's Email
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Father's Phone
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Emergency Contact other than parents
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Relationship to you:
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Phone Number
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I hereby grant permission to Highland Christian Church to use photographs and/or video of me taken during youth group in publications, news releases, online, and other communications related to the mission of Highland Christian Church's Ignite Ministries and the Youth Group Ministries.
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What is your age?
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Less than 13
13-18
19-25
26-35
36-50
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What is your household income?
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Less than $10,000
$10,001 - $25,000
$25,001 - $40,000
$40,001 - $70,000
$70,001 - $100,000
Greater than $100,000
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Home
Youth/Young Adult Groups
Ignite Registration