Lock In - May 29th- Sign Up and Permission

5-29-26 | Please fill out this form and click submit to attend our youth lock in on May 29th from 8pm-8am.

Student Name

*

Student Email

Student Phone

*

Student Address

*

Student Grade

*

Please select one option.

6th 7th 8th 9th 10th 11th 12th

Gender

*

Please select all that apply.

Male Female

Food Allergies

*

Please select one option.

Yes No

List any Allergies

*

Parent/Guardian Information (Emergency Contact)

Name

*

Phone

*

Email

*

Permission of Guardian

By signing this permission slip, I understand the following:

All youth must be in grades 6-12 only.

Parents must provide a phone number where they can be reached during the evening in case

of emergency.

Parents will be called to pick up their teen if the teen leaves the building for any length of time

and/or acts in a manner deemed unacceptable by the Youth Ministries Leaders and/or Parent Chaperones.

Parent or Guardian Name

*

By checking this box I agree to my child staying at Ardent Church and hold Ardent Church harmless i

*

Please select all that apply.

I Agree

Description

5-29-26

Please fill out this form and click submit to attend our youth lock in on May 29th from 8pm-8am.

Please Fix the Following

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