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Personal Information Form

Second Presbyterian Youth
Louisville, Kentucky

Event: 2021-2022 Youth Group Trips & Events

Participant Information

Last Name:

First Name:

Preferred Name:

Youth Cell:

Address:

City:

State:

Zip:

School:

Grade:

Birthday:

Youth Email:

Parent/Guardian Contact Information

Names of Parent(s) Youth Lives With:

Mom/Stepmon info:

Cell Phone:

Work Phone:

Email:

Dad/Stepdad info:

Cell Phone:

Work Phone:

Email:

Names of Parent(s) Youth does NOT Live with:

Mom/Stepmon info:

Cell Phone:

Work Phone:

Email:

Dad/Stepdad info:

Cell Phone:

Work Phone:

Email:

Information

Office Hours

MON–FRI: 9:00am – 4:00pm

SAT–SUN: Closed

Address

3701 Old Brownsboro Road

Louisville, KY 40207

Contact

info@2ndpreslou.org

+1 502.895.3483 office

+1 502.897.9025 fax

Morning Worship

9:00am—Chapel

Faith Formation

Worship Service

11:00am—Sanctuary & Online

Click here for YouTube link

Sharing grace …

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