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• • Address *
    
    Street Address
    
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    Country
• • Primary Parent Email *
    
    
• • Primary Phone Number *
    
    
    
    
    
    
• • Student's cell phone number *
    
    
    
    
    
    
• • Grade in School *currently* *
    ...9th Grade10th Grade11th Grade12th GradeAdult Leader
    
• • T-Shirt Size *
    ...SmallMediumLargeX-Large
    
• • Ethnicity *
    ...Alaskan or Native AmericanArab or Middle EasternAsian or Pacific IslanderAfrican DescentLatino/aCaucasian/WhiteMultiracial
    
• • Age student will be at the Gathering *
    
    
• • This is my first ELCA Youth Gathering *
    Yes
    No
    

• • ---

• • Name of Emergency contact (other than parent) *
    
    First
    
    Last
• • Relationship *
    
    
• • Emergency Day Phone Number *
    
    
    
    
    
    
• • Emergency Evening/Cell Phone Number *
    
    
    
    
    
    

• • To Register

    Double check that your information is correct before you submit, then there is an option to pay online. Return to the Sr. High Ministry page to find the link. The deposit is $150 and is not refundable.
• • Payment Type *
    Online non-refundable deposit ($150)
    Mail or drop off a non-refundable deposit check ($150)
    
• • By clicking these boxes I give permission: *
    for my child to attend the NYG with Westwood Lutheran Church
    for Westwood Staff to seek necessary medical attention.
    

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