Youth Ministry | Email List

Thank you for your interest in joining our Youth Ministry email list. We are glad you are here!

If you have any questions, please contact cym@nativityburke.org

Parent/Guardian Information
Parent 1 Name*
First Last
Parent 1 Email*
Parent 1 Cell Phone*
Parent 2 Name
First Last
Parent 2 Email
Parent 2 Cell Phone
Student Information
Add Students
Please add all students in your home grades 5-12
Child's Name DOB Grade School Cell Phone
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Child's Name*
First Last
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Child's Birthday*
MM slash DD slash YYYY
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Child's Grade*
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Child's School*
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Child's Phone
Phone
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Child's Name	DOB	Grade	School	Cell Phone

Parent/Guardian Information