AASM Registration Form 22/23

Welcome to Asian-American Student Ministries (AASM) 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 AASM in the past. If you're unsure about getting involved in AASM on Friday nights, filling out this form is the best way to stay connected & up to date on AASM events.

*Student First Name:

*Student Last Name:

*Student Email (NA if no email):

*Address:

*City:

*State:

*Zip Code:

*Student Cell Phone (NA if no cell):

*Gender:

*Birthdate:

*What grade are you in 2022/23?:

*What school do you attend?:

What church do you attend?:

Allergies or special dietary concerns:

_________________________________________

*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:

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:

Feel free to share any additional info that would be helpful for us to know.:

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