2017-2018 Youth Ministry and Faith Formation Registration Form
Please fill out this form to register your family for youth ministry, faith formation, and sacramental prep at IC/OLPH. This survey matches the paper version of the registration form. You may register up to four youth on this form. You can direct any questions to tony@ic-olph.org and we will help you out right away.
Mother/Guardian Information
In this section please enter information about the family's mother/guardian. Please make sure there is a phone number and email for at least on parent/guardian.
First name
Your answer
Last name
Your answer
Phone number
Your answer
Email address
Your answer
Father/Guardian Information
In this section please enter information about the family's mother/guardian. Please make sure there is a phone number and email for at least on parent/guardian.
First name
Your answer
Last name
Your answer
Phone number
Your answer
Email address
Your answer
Other Family Information
Please enter other information related to the family.
Family street address *
Your answer
Family city, state, and zip code *
Your answer
What language do you speak at home? *
Your answer
What parish is your family registered at? *
Name of emergency contact *
Your answer
Phone number for emergency contact *
Your answer
Youth #1 Information
Please enter information for one child here.
First name *
Your answer
Preferred name (if not their first name)
Your answer
Last name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Grade (in fall 2017) *
Your answer
School (in fall 2017) *
Your answer
Adult t-shirt size *
Please mark the sacraments this youth has received... *
Required
Will this youth be preparing for any sacraments this year? *
Required
Any other information? Health concerns?
Your answer
Youth #2 Information
You may continue to the bottom if you have entered all of your children.
First name
Your answer
Preferred name (if not their first name)
Your answer
Last name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Gender
Grade (in fall 2017)
Your answer
School (in fall 2017)
Your answer
Adult t-shirt size
Please mark the sacraments this youth has received...
Will this youth be preparing for any sacraments this year?
Any other information? Health concerns?
Your answer
Youth #3 Information
You may continue to the bottom if you have entered all of your children.
First name
Your answer
Preferred name (if not their first name)
Your answer
Last name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Gender
Grade (in fall 2017)
Your answer
Grade (in fall 2017)
Your answer
School (in fall 2017)
Your answer
Adult t-shirt size
Please mark the sacraments this youth has received...
Will this youth be preparing for any sacraments this year?
Any other information? Health concerns?
Your answer
Youth #4 Information
You may continue to the bottom if you have entered all of your children.
First name
Your answer
Preferred name (if not their first name)
Your answer
Last name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Gender
School (in fall 2017)
Your answer
Adult t-shirt size
Please mark the sacraments this youth has received...
Will this youth be preparing for any sacraments this year?
Any other information? Health concerns?
Your answer
Final Signature
One last section.
Name of signing parent/guardian *
Your answer
In case of emergency, and I cannot be reached, I hereby authorize emergency medical treatment for the above students in my care. Additionally, I give my permission to allow photos of the above students to be used in parish promotional materials. *
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