HSM Connect Form 2019-2020

Please complete this form to register for Home Group for the upcoming year of 2019-2020. If you were a part of HG last year, you will need to reregister. If you have questions, feel free to contact the HSM staff at hs@blackhawkchurch.org.

Student/Parent Information:
*Student First Name:
*Student Last Name:
Student Email:
Student Cell Phone:
*Street Address:
*City:
*State:
*Zip Code:
*Gender:
*Birthdate:
*Graduation Year:
*School:
_________________________________________
*Parent 1: First Name:
*Parent 1: Last Name:
*Parent 1: Cell Phone:
Parent 1: Home Phone:
*Parent 1: Email:
Parent 2: First Name:
Parent 2: Last Name:
Parent 2: Cell Phone :
Parent 2: Home Phone:
Parent 2: Email:
Home Group Information: 

Home Groups meet in 7 different locations on Wednesday nights from 7-9 pm. Please choose the Home Group location that you are registering for.
*HG Location:
Please list two friend requests (same gender):
Please list two leader requests (same gender):
*Did you attend Home Group previously?:
Which Home Group were a part of?:
Who were your small group leaders?:
Appearance Release: As the legal parent/guardian for the minor child/student attending this programming, I understand that photographs and/or videos may be taken of my minor child/student during the course of this programming. I authorize and consent to the use of images or videos of my minor child/student by Blackhawk Church for purposes including, but limited to, promotional materials, internet posts including social media, and other media sources.
Consent:
Submit Form