LJ3 REGISTRATION

Junior High Small Groups

JR High - LJ3 Form

By registering, you agree to be bound by the terms of Calvary Chapel of Philadelphia's Resolution on Participation in Church Activities.

Student Name(Required)

First Last

Grade(Required)

School(Required)

Parent/Gaurdian Phone(Required)

Parent/Gaurdian Email(Required)

Address(Required)

Street Address City State ZIP / Postal Code

I would like to be placed ini a group with:

*6th grade only | We will try to accommodate

Please list any food allergies

Student Signature(Required)

I understand that by signing my name, I am in agreement with the guidelines listed above. Failure to comply with the above could result in my being asked to step out of the small group.

Parent/Guardian Signature(Required)

I understand that by signing my name, I am in agreement with the guidelines listed above. Failure to comply with the above could result in my being asked to step out of the small group.