Parents/guardians, please register your Jr. high here so that we can keep attendance on your student! 

This ensures that we are not only know when they are here, but also have all contact information and emergency info on record! 

Student's Name *
Student's Name
Gender *
Medical/Parental Information
Parent/Guardian Name *
Parent/Guardian Name
Home Phone Number *
Home Phone Number
Cell Phone Number
Cell Phone Number
Home Address *
Home Address
Emergency Contact
Please list details for who we should contact in the case of an emergency.
Emergency Contact Name *
Emergency Contact Name
Emergency Contact's Phone Number *
Emergency Contact's Phone Number
Permission for Videotaping/Photography *
I hereby give consent for this student to be photographed or videotaped for use by staff of Woodvale Student Ministries, a ministry of Woodvale Pentecostal Church. Use of these pictures/footage may or may not be viewed/used at Boost Jr. High, Intencity Youth and/or posted on our website at By checking this box you agree you have read, understand and agree to the Woodvale Church Permission for videotaping/photographing stated above.
Waiver *
I/We permit my/our child on this form to take part in Boost Jr. High Ministry and agree to waive any claims upon Woodvale Pentecostal Church (or any of its agents) in the event of injury, loss, or damage (however caused), that may be sustained by the above-mentioned child, while taking part in this ministry indicated here, and in all matters relating to Boost Jr. High organized by Woodvale Pentecostal Church. I/We understand the risks involved in the nature of Boost Jr. High Ministry,