Youth Group - EDGE & LIfeTeen
Please fill out one form for each child and click submit.
Name
*
Sex:
*
Please select all that apply.
M
F
Date of Birth
*
Grade Level for Current Year
*
Email
*
This address will receive a confirmation email
Phone
*
Address
*
--
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
My Child Has Received The Following Sacraments (please check all that apply)
*
Please select all that apply.
Baptism
First Communion
Confirmation
Please list any special needs (allergies, learning differences, etc.)
*
Parent/Guardian Information
Father's Name
*
Father's phone number
*
Father's email
*
This address will receive a confirmation email
Mother's Name
*
Mother's Phone number
*
Mother's email address
*
This address will receive a confirmation email
Please list an additional emergency contact person with their name, phone number and relationship.
*
Parent/Guardian Consent & Agreement
Please read below and check that you agree to each.
I agree to release Our Lady of Grace Catholic Church (OLGrace) and anyone affiliated with the parish and will hold harmless from any liability which may arise from incidents or accidents involving my child during participation of Religious Education (RE) & Youth Group classes or activities or retreats, to extent allowed by law.
*
Please select all that apply.
Agree
I give OLGrace and anyone affiliated with the parish permission to photograph my child during RE or Youth Group classes/ activities/ retreats & post photos on the parish and program Facebook/Instagram (Social media), website, bulletin boards & church bulletins. ed
*
Please select all that apply.
Agree
I understand that excessive absences and/or failure to fulfill sacrament requirements means my child will need to repeat sacramental preparation.
*
Please select all that apply.
Agree
A payment of $10 for each child registered is required at time of registration. If you need to pay by cash or check please register in person at the parish office of after Masses in the foyer. This form is not for confirmation students. Confirmation students must pay in person and are required to pay a fee of $20 per student.
$10.00
Credit/Debit Card Number
Expiration Date/CVC
Name on Card
Card Billing Address
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Submit
Description
Please fill out one form for each child and click submit.
×
Please Fix the Following
