RE:BOOT REGISTRATION

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Register here for RE:BOOT. Please make sure to include email and/or phone number,

For more information visit http://saintgregorychurch.org/faith-formation/youth/reboot

First Name

Last Name

Phone

I am interested in attending

February 11 | Screenagers @ 10am in the Gym

February 25 | Discussion 1 @ 10am in the Worner Center || "Families & Screen Time" & "People Over Screens“

March 11 | Discussion 2 @ 10am in the Worner Center || : "The Modern Time Crunch" & "Video Games & Social Media"

March 25 | Discussion 3 @ 10am in the Worner Center || "Setting Healthy Limits" & "Writing a Family Agreement"

Will you be taking a break from technology during Lent? (Technology Fast)

Yes

Maybe

Clear selection

We currently are NOT offering childcare for the movie screening or discussions. IF we can provide it, will you need it?

Yes

Clear selection

For how many children?

How old are the children for which you will need childcare?

4 Years Old

5 Years Old

6 Years Old

7 Years Old

8 Years Old

9 Years Old

10 Years Old

11 Years Old

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report