2021-2022 Youth Ministry Registration Form PLEASE COMPLETE A SEPARATE FORM FOR EACH YOUTH REGISTERED.

2021-22 Youth Ministry Registration Form

PLEASE COMPLETE A SEPARATE FORM FOR EACH YOUTH REGISTERED.
Youth's Name *

First Name Last Name
Youth's Email Address
Youth's Cell Number
Primary Parent Contact's Name *

First Name Last Name
Primary Contact's Email Address *
Primary Contact's Phone Number - In case of Emergency *

Area Code Phone Number
Additional Adult Authorized to Pick Up your Youth

First Name Last Name
Secondary Email Address
Secondary Phone Number *

Area Code Phone Number
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Youth's Date of Birth *

Month Day Year
Any Allergies?
Attending which Youth Group? *
Youth Attends Which School?
If needed, could you help provide transportation to a Youth Group activity? *

Yes, I could drive if needed. I would prefer not to drive.
May we use photos of your youth, taken during church events, on the St. Alban's website and/or other parish communications? (Youth will not be identified by name.) *

Yes No
Any special needs or concerns you would like to share regarding your youth?
Should be Empty:

2021-22 Youth Ministry Registration Form