2025-26 UpStreet Registration Form

Date Of Birth *

MM

DD

YYYY

Child’s Gender: *

Male

Female

Shirt Option *

To help cover costs, we’re asking a $10 donation per shirt.

I'll pay $10 at registration

I'll pay on tithe.ly

Please scholarship my shirt

I'd also like to Sponsor another child's shirt

Name of Parent(s) *

First Name

Last Name

Cell Phone *

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Are parent(s) helping with UpStreet? *

Yes

No

Type Today's Date *

MM

DD

YYYY

In Case of Emergency, & parent above cannot be reached... Please Contact *

Please list a secondary contact person in case the person above cannot be reached. Ex: other parent, relative, etc.

First Name

Last Name

Phone *

(###)

###

####

Does your family plan to join us for dinner at 5:15pm?

Yes, we'll be there

Maybe a few times

No, we can't make it