| Church Name: |
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| Contact Person: |
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| Contact Phone: |
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| Contact Email: |
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| Class Name |
Youth Name and Grade (John Jones - 11th) |
High School Class #1: MyBody: Overcoming Tempation |
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High School Class #2: MyMind: Making the Right Decisions |
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Junior High Class #1: MyMind: Making the Right Decisions |
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Junior High Class #2: MySpirit: Leading the Way for Christ |
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Pre-K and Kindergarten: (Please list name and grade) |
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1st-3rd Grade: (Please list name and grade) |
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4th and 5th Grade: (Please list name and grade) |
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Will you have a song group (Limit 2 songs) |
Yes No |