2017 St. Anne & Eastside Parishes Individual NCYC Registration
Registration Deadlines:
• Priority Registration: Friday, May 26, 2017
• Delayed Registration: Friday, September 22, 2017

Direct all questions to your parish youth leader or school campus minister.

First Name *
Your answer
Last Name *
Your answer
Parish of Membership *
Group You Are Registering with *
First Name or Nickname You Would Like Printed on the Conference Name Badge *
Your answer
T-Shirt Size *
All sizes are standard adult sizes
Gender *
Date of Birth *
MM
/
DD
/
YYYY
Address *
Your answer
City *
Your answer
State *
Zip Code *
Your answer
Participant Email *
Your answer
Primary/Home Phone *
Your answer
Participant Cell Phone *
If you do not have a cell phone number to share, please enter 000-000-0000
Your answer
I Am Registering as: *
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