Make It or Break It Registration Form
Email Address (that you will be checking)
Will you be 18 or older by August 5th, 2017?
I am 18 years or older
I am not currently 18 or older, but I will be by August 5th, 2017
I am not 18 or older and will not be by August 5th, 2017
What year did you graduate high school?
What high school did you attend?
What year in college are you going into this fall?
What college do you attend or will be attending?
What parish are you a member of?
Did you attend a youth group or HSA?
I am part of a youth group and a member of HSA
I am part of a youth group only
I am part of HSA only
I am not part of a youth group or a member of HSA
By clicking here I give permission to the organizers to take photos and videos that include me and to use these images to promote the mission of the Diocese of Bridgeport.
Do you have any dietary restrictions?
A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
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