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Fix My Eyes On You Youth Rally
Please complete this form to sign up to as a fifth- or sixth-grade student to attend the Youth Rally on Sunday, Aug. 27 at St. Clare School. Doors open at 2:45 p.m. and the rally is from 3 to 5:30 p m.
Make sure you click the submit button at the end of the form.
Student's last name *
Your answer
Student's first name *
Your answer
Nickname for name tag (if different than first name)
Your answer
Street address *
Your answer
City *
Your answer
Zip code *
Your answer
Parent's email address *
Your answer
Parent's phone number *
Your answer
Grade *
Parish *
Father's first and last name
Your answer
Mother's first and last name
Your answer
Medical considerations/food allergies *
Your answer
Emergency contact name during event *
Your answer
Emergency contact phone during event *
Your answer
I hereby authorize my son/daughter to attend the Youth Rally and have his or her photograph taken for parish publications, websites and videos. *
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