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Youth Registration Form
We are so excited that you are choosing
to be a part of CityLight on Wednesday nights!
Please submit a separate form for each child and/or teen.
Child/Teen's First Name
Child/Teen's Birthday (Age)
Child/Teen's Last Name
Child/Teen's Grade in Fall of 2025
Any Allergies?
Parent/Guardian's First Name
Parent/Guardian's Last Name
Parent/Guardian's Email
Parent/Guardian's Phone
Street Address
City
Region/State/Province
Postal / Zip code
Submit Registration
Thanks for registering! See you soon!
Do you have a question?
Please let us know and we'll be happy to get right back with you!
Send
Thanks! Message sent.
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