YouthMax Registration Page - ALAS | Always Learn and Survive

Student Information

Name(Required)

First Last

Age(Required)

Address(Required)

City(Required)

State(Required)

Zip Code(Required)

Home Phone

Cell Phone

School(Required)

Birth Date(Required)

Email(Required)

Is the student bilingual?(Required)

Yes

No

If yes, what languages does the student speak?(Required)

Is your teen on Facebook?(Required)

Yes

No

Parent Information

Mother's Name(Required)

Father's Name(Required)

Do both parents live at home?(Required)

Yes

No

Is it ok to email you updates regarding youth events?(Required)

Yes

No

Address (if different from teens or non-primary parent)

City

State

Zip Code

Mom's Cell Phone(Required)

Dad's Cell Phone(Required)

Mom's Email

Dad's Email

Are you on Facebook?(Required)

Yes

No

Emergency Contact Name(Required)

First Last

Emergency Contact Relationship to Youth?(Required)

Emergency Contact Phone Number(Required)

Trust Person Allowed to Pick Up Youth(Required)

First Last

Trust Person Phone Number(Required)

Parent Sign Ups

I would be willing to help out the youth group in the following manner:(Required)

bake treats for youth events

help in the kitchen for varying events

drive students to youth events

other

Parental Permissions

Please Sign Media Release(Required)

By signing the following I agree to let pictures of my child appear on the ALAS website, the youth group Facebook page, or in print publications by ALAS, Always Learn and Survive.

Please Sign Travel Release(Required)

The youth leaders and coaches of ALAS have planned events throughout the year that will take place off ALAS property. While we care deeply for each child placed under our care and endeavor to exercise the utmost care and caution, accidents do happen, and we can in no way guarantee the safety of each person. By giving your consent, you hereby agree to accept the risk and responsibility associated with these activities. You hereby further agree to waive any and all claims against ALAS, Always Learn And Survive or any of its staff members and volunteers.

Today's Date(Required)

Printed Name of Parent/Guardian(Required)

First Last

Student Volunteers

Signature of Student Volunteer

I understand that in serving as a volunteer at ALAS that I am willing to abide by the Policies and Procedures set forth in the Risk Management Program to reduce the risk of Child Abuse. I understand that child abuse is a serious matter and will do my part in the prevention of child abuse while serving at ALAS, Always Learn And Survive.

Today's Date

Printed Name of Student Volunteer

First Last

Signature of Parent/Guardian

I do not know of any reasons why my child should not serve as a Teen volunteer with minors. They do not demonstrate any signs of being a potential risk to ALAS, Always Learn And Survive

Today's Date

Printed Name of Parent/Guardian

First Last

YouthMax Registration Form

Student Information

Parent Information

Parent Sign Ups

Parental Permissions

Student Volunteers