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SPX CYO Registration Form
Open to students in grades 8 - 12 who wish to participate in St. Pius X Parish Catholic Youth Organization
Teen's First Name *
Your answer
Teen's Last Name *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Home Phone
Your answer
Teen's Cell Phone *
Your answer
Twitter username
Your answer
Instagram Username
Your answer
Snapchat Username
Your answer
School as of Fall 2017 *
Your answer
High School Graduation Year (Class of...) *
Your answer
Birthdate (mm/dd/yyyy) *
Your answer
Father's Name
Your answer
Father's Cell Phone
Your answer
Father's Email
Your answer
Father's Workplace
Your answer
Mother's Name
Your answer
Mother's Cell Phone
Your answer
Mother's Email
Your answer
Mother's Workplace
Your answer
Is there anything else you would like to share with us?
Your answer
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