Courthouse Community Student Ministries
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How are you related to the youth program?
I'm a parent
I'm a grandparent
I'm a bonus-parent (step)
I'm a guardian
Other (Please explain in comments below)
If you chose "other" above, please explain.
Daytime Phone Number
Cell Phone Number
Text @ccumcPMT to 81010 to opt in to our Parent texting
Text @ccumcYouth to 81010 to opt in to our youth texting
Please indicate whether or not you have been through the CCUMC child safety/safe sanctuaries training (green lanyard) class in the last three years. If you've participated in other clearance processes for your employer, please list that in the space provided.
No, not trained
I've trained elsewhere (see below)
Please provide details for "I've trained elsewhere" option of child safety training question.
Youth & Parents filling this out - please list name, grade, school - for yourself or your student, along with any brothers/sisters and their grade/school. If graduated, please include year of graduation, current status (at JMU, entered workfroce, military). Thank you!
Please contact me! I would like to . . .
receive a phone call
receive an email
receive more information
learn more about this program
meet to talk
ontact the Director of Student Ministries
Courthouse Community United Methodist Church
2708 Princess Anne Road, Virginia Beach, VA 23456