HSM Registration Form 2021/22

Welcome to High School Ministry at Blackhawk Church! To help us plan well for the ministry year, we are asking that you fill out this registration form even if you have been involved in HSM in the past. If you're unsure about Wednesday night Community Groups (formerly Home Groups), filling out this form is the best way to stay connected & up to date on HSM. If you have questions, feel free to contact the HSM staff at hsm@blackhawkchurch.org.
*I am filling out this form to:

Student/Parent Information:
*Student First Name:
*Student Last Name:
Student Email:
Student Cell Phone:
*Street Address:
*City:
*State:
*Zip Code:
*Gender (for assigning small groups) :
*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:
*
We would like to help facilitate sharing contact information amongst parents in each Community Group so parents have an opportunity to connect with others in the same stage of life. Would you like to opt in to sharing your contact information with other families?
Community Groups Information: 
Community Groups (formerly known as Home Groups) are geographically based with an option to meet online or in-person at either a Blackhawk site or a site in Waunakee or Mount Horeb. With this in mind, which Community Group would you like to attend? 
*Community Group :
Please share any friend or leader small group requests (for assigning small groups):
*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:
Thank you for completing the form, we look forward to connecting with you! If you have any questions regarding Community Groups or general High School Ministry information, please feel free to let us know and someone from our staff team will be in contact with you!