subject_line
Youth First Name
*
Youth Last Name
*
Gender
Male
Female
Age
*
Grade:
Current School
Birthday
*
Parent/Guardian Name
*
Street Address
*
City
*
Postal Code
*
Youth's Cell Phone Number
🛈
Parent/Guardian Phone Number
*
Email Address
*
Pick Up Authorization
🛈
I am connected to The Neighbourhood Church through:
*
I am a friend of someone in Amplify Youth
I am part of Amplify Youth
How did you hear about our House Hopping Retreat?
*
Been to a previous The Neighbourhood Church event
Referred to by a friend
Saw promotional material
Other:
Other:
Help us out! What AMAZING event or activity should The Neighbourhood Church Amplify group plan next!
*
One thing people should know about me is...
*