Event Registration

Student's Name:

Parent's Name:

Event Name (ie: Henlopen, Parents Night Out etc:)

Parent e-mail:

Parent phone:

Medications Student is taking:

All medication information will be kept private.

Comments:

By pressing submit, you are confirming your student's attendance at this event. You will receive an e-mail confirmation from Hopewell Youth Ministries confirming your sign-up within three days. Thank you!