2019 Youth Alpha Registration
Sessions begin Sunday, January 13th! Please ask your parent's permission before signing up! More information can be found at www.sjncanton.org/youth-alpha. This program is being provided for free but is a significant cost to the parish, please do not fill out this form until you are absolutely sure that you will be able to attend the program. Don't forget to invite your friends to sign up too!
Participant First Name *
Your answer
Participant Last Name *
Your answer
Participant Date of Birth *
MM/DD/YYYY
Your answer
Grade in School *
All participants must be in grades 8-12.
Street Address *
ex. 44800 Warren Road
Your answer
City Address *
ex. Canton
Your answer
Zip Code *
Your answer
Participant Phone Number *
ex. 734-455-5910
Your answer
Does the participant receive text messages? *
Participant E-Mail Address *
Your answer
Parent Name(s) *
ex. Larry and Barbara
Your answer
Parent Phone Number *
ex. 734-455-5910
Your answer
Does the parent receive text messages? *
Parent E-Mail Address *
Your answer
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