New Student Form

Full Name *Enter your full name.

Preferred Name/Nickname This is an optional description of the field.

What school do you go to? This is an optional description of the field.

What's your birthday? Select the date.

Parent/Guardian Name *This is an optional description of the field.

Parent/Guardian Phone *This is an optional description of the field.

Parent/Guardian Email This is an optional description of the field.

Have you been to Rocky Mount before? This is an optional description of the field.

What are some things you like to do for fun? This is an optional description of the field.

What are you most excited about in youth group? This is an optional description of the field.

Is there anything you want our youth pastor or leaders to know? This is an optional description of the field.