Youth Group Registration

Thank you for your interest in our Youth Ministry program here at San Jose. Please complete the registration form to receive all the latest news and activities for our Youth Group!
  • Today's Date
    MM slash DD slash YYYY
  • Please enter your date of birth
    MM slash DD slash YYYY
  • Youth's cell phone number
  • Youth's email
  • What school do you attend
  • Family Information

  • Name of Parent or Guardian responsible for Youth Registrant