Byml: BLAST Youth Ministry International 
 
 
blast-logo-9-16
Valleyview NewL!FE Church
          BLASTyml:          Youth Ministry International
 
!!
 
                   We welcome                        
                  Advisory Pastor                                Stephen Rymarz                    
and incoming, July 2017,  
Youth Leader
 
Charlie McGraw
 
as our
Youth Ministry TEAM Leaders
 

Valleyview NewLife Church, 455 Murray Ave. and 2450 Valleyview Dr., Columbus, OH 43204, Church: 614-272-2450,                                                          Youth Pastors: 724-931-2940(Marty) & 724-931-2942(Paul)

BLASTym(blast youth ministry)  REGISTRATION

 

Birth DATE________________________________________________

We/I give our/my Child______________________________________

2ndChild__________________________________________________
 
3rd Child__________________________________________________ permission to be in the care of AND/OR ride with AND/OR to be taken to the closest medical facility in an emergency, BY The Valleyview NewLife Church BLAST Youth Ministry LEADERS.
 
____We/I understand that our/my Child is responsible to follow the directions of and stay with the BLAST Youth Ministry LEADERS.
____We/I will not hold the Valleyview NewLife Church liablefor accidental  injury of our/my child.

____We/I have given the Valleyview NewLife Church BLAST Youth Ministry all the proper information about our/my child, including:

 

Medical/Behavioral Health Information  ___________________________________________________________________________________________________________________________________________________________________________

Personal Information

___________________________________________________________________________________________________________________________________________________________________________

Custody Information

  

__________________________________________________________________________________________________________________________________________________________________________________________

 

Other Necessary Information

___________________________________________________________________________________________________________________________________________________________________________

Parent/Guardian Signature

_________________________________________________________

Family Resident Address & Phone Number

_________________________________________________________

Emergency Phone Numbers/Relationship

_________________________________________________________

 

BLASTym LEADER receiving this information: _________________________________________________________  Date:______________________              Time: _____________________

 

YOUTH Survey:                                                                                                                                                                                                         

Favorite things to do:

 

Music I listen to:

 

What I am reading to get motivated:

 

What I’m best at:

 

What I’m worst at:

 

Things I would like to experience in my lifetime:
 
 
 
 
Copy & Paste to a blank Word Document.  Fill out and Attach to our email: marty_pastor@yahoo.com.  Subject: bymi Registation..