Core Registration

Student Information

Student Name*

First Last

Student Birthdate*

MM

DD

YYYY

Gender*

Student Address*

Street Address Address Line 2 City ZIP Code

Student Main/Home Phone*

Student Cell Phone

Cell Phone Carrier (ie. Verizon)

Student Email

Grade*

6th
7th
8th

Name of School*

Allergies and/or Special Needs

Is there anything we should know about your child that will enable us to better serve your child? If so, please describe them above or call to discuss.

How did you hear about CORE?*

Parent One Information

Parent 1 Name*

First Last

Parent 1 Address*

Street Address Address Line 2 City ZIP Code

Parents 1 Main Phone*

Parent 1 Cell Phone*

Parent 1 Email*

Parent 2 Information

Parent 2 Name

First Last

Parent 2 Address

Street Address Address Line 2 City ZIP Code

Parent 2 Main Phone

Parent 2 Cell Phone

Parent 2 Email

Friend Request For Small Group Assignment

6th grade students will complete a friend request card at CORE in September. Returning 7th and 8th grade students may choose to stay with their group from last year or move to a different group. Notify Student Ministry staff by 9/7 if you would like to move to a new group or enter a friend/mentor request below. We will place you with the same group from last year unless we hear differently from you. New 7th and 8th grade students, please enter a friend request below. If possible, we will place you with students from your same school if you do not have a request.

Friend Request

First Last

Mentor Request

First Last

Parent Permission

The registrant has my permission to participate in Pathfinder Student Ministry programs and related activities, to include the Sunday morning middle school CORE program. I understand that when participating in Pathfinder Student Ministry activities, the registrant may be photographed for print, video, or electronic imaging. I understand the images may be used in promotional materials for Pathfinder Church. I acknowledge the images will be the sole property of Pathfinder Church.

Click below to accept*

I accept

6th-8th Grade

Student Information

Parent One Information

Parent 2 Information

Friend Request For Small Group Assignment

Parent Permission