ENGAGE Youth Event Registration Form

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We are extremely excited to have your child on campus for the ENGAGE Youth Event this year!

We hope and pray this experience will provide a small glimpse of campus life and our heart for teaching faith based education to you student.

Please take a couple of minutes to fill out this contact form.

If you have any questions, please reach out to Kelli Croucher ([email protected]).

Participant First Name

required

Participant Last Name

required

Gender

required

Participant Phone

required

Participant Email

required

High School Name

required

Anticipated Graduation Year

required

Parent/Guardian First Name

required

Parent/Guardian Last Name

required

Parent/Guardian Phone

required

Parent/Guardian Email

required

Home Address

required

City

required

State

required

Zip Code

required

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