LTCC YOUTH

Parent Questionnaire

Parents' Names

Parent Phone

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Parent Email

Student(s) Names

Student Food Allergies

Are you interested in a small group?

My student wants to attend the wednesday small group from 7:30-9pm.

My student wants to attend a small group but not on Wednesday.

We want to host a small group in our home.

We want to host and lead a small group in our home.

Our student is not interested.

Will your Student be attending you group on Sundays from 4-6pm?

Yes

No

Would you be interested in helping with student events?

Yes

No

How would you like to help?

Specific events, skills, resources, ideas, event locations, etc.

How can we be praying for your family this school year?

Other info you would like us to know