Our Lady of the Assumption LifeTeen Permission Form
Fall LifeTeen Retreat: October 12 -14 //$130 **starting October 8, $20 late fee**
Culture Project Day Retreat: January 20 //$30
Walk for Life: January 26
Spring LifeTeen Retreat: March 8 - 10 //$130 **starting March 4, $20 late fee**

Please fill out one per child, thank you!

Basic Information
Teen Last Name *
Your answer
Teen First Name *
Your answer
Sex *
Teen Cell Phone *
Your answer
Date of Birth *
Address *
Your answer
State *
Zip Code *
What is your religious affiliation?
What parish do you attend? *
Shirt Size *
School *
Age *
Grade *
Mother/Guardian First and Last Name *
Your answer
Mother Cell Phone *
Your answer
Father/Guardian First and Last Name *
Your answer
Father Cell Phone *
Your answer
Which events does this form apply to?
Check all that apply. *Checking a box is not a commitment to attending that event*
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