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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.
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I am filling out this form to:
Register for HSM Community Groups (new to ministry)
Register for HSM Community Groups (was part of Home Group in previous years)
Get on the email list to stay up to date with HSM (not registering for Community Groups)
Student/Parent Information:
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Student First Name:
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Student Last Name:
Student Email:
Student Cell Phone:
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Street Address:
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City:
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State:
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Zip Code:
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Gender (for assigning small groups) :
-- Select --
Female small group
Male small group
Undecided
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Birthdate:
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Graduation Year:
-- Select --
2022
2023
2024
2025
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School:
_________________________________________
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Parent 1: First Name:
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Parent 1: Last Name:
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Parent 1: Cell Phone:
Parent 1: Home Phone:
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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?
Yes
No
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?
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Community Group :
In-person Waunakee (Waunakee site)
In-person Blackhawk Brader Way site (Middleton East)
In-person Blackhawk Brader Way site (Middleton West)
In-person Blackhawk Fitchburg site (West Madison)
In-person Blackhawk Fitchburg site (Fitchrona)
In-person Mount Horeb (in-person at Mount Horeb site)
Online (online via Zoom)
No Community Group at this time
Please share any friend or leader small group requests (for assigning small groups):
*
Did you attend Home Group previously?:
Yes
No
Which Home Group were a part of?:
-- Select --
MSM or HSM Waunakee
MSM or HSM Middleton East
MSM or HSM Middleton West
MSM or HSM West Madison
MSM or HSM Mount Horeb
MSM Fitchburg
MSM Verona
MSM Oregon
HSM Fitchrona
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.
Appearance Release Consent:
-- Select --
I authorize and consent
I do not authorize and 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!
Submit Form