Respect Life Club Registration form - Grades 6-8
Respect Life Club -

There will be fun activities and dynamic discussions that highlight the value of human life from conception to natural death. Topics will be based on the three R’s:

RECOGNITION of how everyone is special
RESPECT for all members of our human family
RESPONSIBILITY toward ourselves and others

Please complete a registration form for each participant. Club registrations are a first come first serve basis and are limited to the first 20 students. You will receive notification when your club fee of $5 is charged in FACTS to cover expenses.

All payments will be processed through FACTS. Thank you.

Wednesdays, November 7, 14, 28
2:45 to 4:00 PM (dismissal from gym doors)

Please direct any questions or for more information to
Email address *
Student's Last Name *
Your answer
Student's First Name *
Your answer
Student's Grade *
Class *
Parent's Last Name *
Your answer
Parent's First Name *
Your answer
Cell Phone Number *
Your answer
Emergency Contact Name *
Your answer
Emergency Phone number *
Your answer
Medical notes or additional information
Your answer
A copy of your responses will be emailed to the address you provided.
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