LifeTeen & Edge Registration Form
Registration form for LIfeTeen & Edge 2019-2020
Student Name *
Your answer
Student Email Address *
Your answer
Mother's Name *
Your answer
Mother's Email Address *
Your answer
Mother's Phone Number *
Your answer
Father's Name *
Your answer
Father's Email Address *
Your answer
Father's Phone Number *
Your answer
Student Lives With *
Emergency Contact Name *
Your answer
Emergency Contact Phone Number *
Your answer
Home Address *
Your answer
Home Phone Number *
Your answer
Sex *
Birth Date *
MM
/
DD
/
YYYY
School *
Your answer
Grade *
Allergies *
Your answer
Special Needs *
Your answer
Sacraments NEEDED *
Required
Sacraments RECEIVED *
Required
Is the student's Baptism certificate on file with the church? *
Student's T-shirt Size *
Registration Payment Options *
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