Epic Registration Form

We have BIG plans this year!!

One of them is more effective communication. To help us out, please provide contact info for both the Parent/Guardian and the Youth. It will keep things simple, allowing us to get the right information to the person who needs it.

Tell us About Yourself

Youth Name

Youth Phone

Youth Email

Birthdate (dd-mm-yyyy)

Gender

Please select one option.

Male Female Prefer not to answer

Current School Grade

Please select one option.

Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12

County of Residence

Please select one option.

Town of Cardston Cardston County Blood 148 Reservation Other

Parent/Guardian 1 Name

Parent/Guardian 1 Phone

Parent/Guardian 1 Email

This address will receive a confirmation email

Parent/Guardian 2 Name

Parent/Guardian 2 Phone

Parent/Guardian 2 Email

Does your youth have any medical conditions, allergies or dietary concerns Epic should be aware of?

By clicking agree/registering my youth with EPIC Youth Services, I hereby agree to allow EPIC to use photographs/videos of my child/myself in social media and website promotions and TERMS OF SERVICE: https://epic-youth.com/index.php/forms/

Please select all that apply.

I have read and agree to the covid waiver and terms of service.

Epic provides free counselling to youth. If you would like your youth to have access to counselling, please read and agree to the COUNSELLING CLAUSE: https://epic-youth.com/index.php/forms/

Please select all that apply.

I have read and agree to the counselling clause.

Epic Registration Form

Description

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