Youth Group Registration

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Registration

Youth group registration for 2017-2018 is now open!

Please use the field below to register and submit optional donation. All donations go towards sustaining our youth group with resources and materials.
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- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Address REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Father's Name Please enter valid data.
- Mother's Name Please enter valid data.
- Teen Address above is the address of Both Parents Mother Father
- Teen Email Please enter an email address.
- Father's Email REQUIRED Please fill out this field. Please enter an email address.
- Mother's Email REQUIRED Please fill out this field. Please enter an email address.
- Teen Cell Number REQUIRED Please fill out this field. Please enter a phone number.
- Father's Cell Number REQUIRED Please fill out this field. Please enter a phone number.
- Mother's Cell Number REQUIRED Please fill out this field. Please enter a phone number.
- Teen's Allergies (if none, type "None") REQUIRED Please fill out this field.
- Date of Birth (dd/mm/yyyy) REQUIRED Please fill out this field. Please enter valid data.
- Sex
- School Attending REQUIRED Please fill out this field. Please enter valid data.
- Grade REQUIRED Please fill out this field.
- Teen has received the following sacraments (check all that apply) Catholic/Christian Baptism Reconciliation Eucharist (Communion) Confirmation
- Teen is currently enrolled in Confirmation Program at Sacred Heart of Mary
- I give permission for photos of my teen partiipating in youth events to be posted on Sacred Heart of Mary's website, Sacred Heart of Mary's weekly bulletin, and/or social media for Sacred Heart of Mary.
  I Agree Please select this field.
- I give permission for the youth director and youth ministers to contact my teen via text and/or email, for upcoming Sacred Heart of Mary youth events and reminders.
  I Agree Please select this field.
- Email to receive registration confirmation REQUIRED Please fill out this field. Please enter an email address.
- Youth Group Donation (optional) $ Please enter a positive decimal.
Total: $

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