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San Jose Youth Ministry Registration

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
  • Select the age appropriate youth program for your child
  • What is the preferred name that you go by?
  • Please enter your date of birth
    MM slash DD slash YYYY
  • Youth's cell phone number
  • Youth's email
  • What school do you attend
  • Please indicate other sizing by selecting other
  • Please share with us any special talents that you have eg. Play a musical instrument - can lick my elbow...
  • Family Info

  • Name of Parent or Guardian responsible for Youth Registrant

Office Hours

Mon - Thurs:
8:30 AM - 4:00 PM
Fri:
8:30 AM - 12:00 PM

Find Us

3619 Toledo Rd

Jacksonville, FL 32217

(904) 733-1630

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