Laser Tag and Sandwich Service
Helping the needy this Winter and having fun at the same time.
Student Name
*
First Name
Last Name
E-mail
*
example@example.com
This email belongs to:
our family
the student
Emergency contact name
*
Must be 18 years old
Emergency contact phone
*
Please enter a valid phone number.
Student's current grade:
*
9
10
11
12
I learned about Assumption Youth Ministries from:
*
Facebook/Instagram
Attending Mass
Church Bulletin
School/PSR
Email
Other
Are you bringing a friend?
Yes
No
If so, how many?
Submit
Should be Empty: