Upstream Ministry Student Registration - High School School

Fill out this form for each Upstream High School Student.

Student Information

Name

This address will receive a confirmation email

Mobile Phone

Birth Date

Gender

Grade this Fall 2022

9th 10th 11th 12th

Parent Information

Parent First and Last Name

Parent's Email

This address will receive a confirmation email

Parent's Mobile Phone

Address

WGBC Member?

Notes

Are you are able to host an Upstream group in your home 3x a month? Yes or No

Description

This form is to register Students for Upstream High School Ministry for the 2022-23 School Year.