Youth Name *

First Name

Last Name

Days of Attendance *

Please check all the days your youth will be able to participate Drop-off: Friday, Dec 20, 2019 | 6PM Pick-up: Sunday, Dec 22, 2019 | 3PM

Fri. Dec 20

Sat. Dec 21

Sun. Dec 22

I would like to give a love offering

This will go toward cost of food and activities (drop off at Youth Check-in Table on Sunday morning)

$10

$20

$30

Other

Annual Youth Reg *

Is your Youth registered for this school year 2019-2020?

Yes, I've registered my youth for this school year

Not yet, I will complete the form by Dec 15, 2019 >> 3stone.breezechms.com/form/0ed508