Registration

Membership Registration Form

PARENT Information

* Indicates required field

PARENT 1 / Primary Contact *

First

Last

PARENT 2 / Secondary Contact *

First

Last

Parent 1 / Primary Email *

Parent 2 / Secondary Email *

Parent 1 / Primary Phone *

Parent 2 or Secondary Phone *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Share Information in Directory *

Neighborhood *

Church or Religious Affiliation *

TEEN #1 Information

Name of Teen #1 *

First

Last

Email of Teen #1 *

Phone Number of Teen #1 *

Nickname of Teen #1 (only if preferred) *

Birthday of Teen #1 *

Age of Teen #1 *

Gender of Teen #1 *

Grade or Grade Equivalent of Teen #1 *

TEEN #2 Information

Name of Teen #2 *

First

Last

Email of Teen #2 *

Phone Number of Teen #2 *

Grade or Grade Equivalent of Teen #2 *

Nickname of Teen #2 *

Birthday of Teen #2 *

Age of Teen #2 *

Gender of Teen #2 *

TEEN #3 Information

Name of Teen #3 *

First

Last

Email of Teen #3 *

Phone Number of Teen #3 *

Nickname of Teen #3 *

Birthday of Teen #3 *

Age of Teen #3 *

Gender of Teen #3 *

Grade or Grade Equivalent of Teen #3 *

Submit

After filling out the registration form, you can pay your dues
using one of these methods:

----PayPal: $20 per teen by clicking the PayPal button below. Verify the number of teens & total before paying. Please add in the Notes that this is for membership & list your teens' first names.
-----Cash or check brought to an event: $20 per teen
-----Check Mailed: If you prefer to pay by check, make check payable to WHHE Teen Group and contact us at whheteeninfo@gmail.com to get the mailing address for our current adult leader serving as our treasurer.

To finalize your membership the following forms need to be completed and turned in for each registered member. Go to this link or visit our Forms page & print them out. http://www.whheteengroup.com/forms.html .

Medical Release - filled out & signed
Teen Code of Conduct/ Policies - read & signed by BOTH the teen and parent as well as initialed accordingly as indicated