MFC-Y Membership Form
Camp Name
*
The first camp this youth attended/will attend.
Chapter
*
Please Select
Mississauga
Brampton
Hamilton
Downtown Etobicoke (DTE)
Durham
Markham-York Region (MYR)
Scarborough Northeast (SNE)
Scarborough Northwest (SNW)
Scarborough Southwest (SSW)
Scarborough Southeast (SSE)
Scarborough Central (SCC)
The chapter this youth is a part of.
Name
*
First Name
Last Name
Nickname
Gender
*
Male
Female
Address
*
Street Address
Street Address Line 2
City
Province
Postal / Zip Code
Email
*
A confirmation email will be sent to this address upon form submission.
Phone Number
*
Format: (000) 000-0000.
Birthday
*
/
Month
/
Day
Year
Date Picker Icon
School - Grade or Year
ex. St. Joan of Arc Catholic Secondary School - Gr. 9
Allergies
Membership in School
and Parish Groups
Groups - Positions
e.g. parish youth group, school chaplaincy, choir, etc.
Other Seminars / Retreats attended:
e.g. extracurricular, religious, leadership, etc.
Hobbies / Interests / Skills:
e.g. playing musical instruments, singing, dancing, creatives, etc.
Parent/Guardian Information
Name of Parent/Guardian #1
*
First Name
Last Name
Parent/Guardian #1 Email
*
example@example.com
Parent/Guardian #1 Phone Number
*
Format: (000) 000-0000.
Parent/Guardian #1 Occupation
Parent/Guardian #1 Groups
e.g. parish prayer groups, men's/women's fraternity, Catholic Women's League (CWL), Knights of Columbus (KofC), etc.
Name of Parent/Guardian #2
First Name
Last Name
Parent/Guardian #2 Email
example@example.com
Parent/Guardian #2 Phone Number
Format: (000) 000-0000.
Parent/Guardian #2 Occupation
Parent/Guardian #2 Groups
e.g. parish prayer groups, men's/women's fraternity, Catholic Women's League (CWL), Knights of Columbus (KofC), etc.
Re: the youth this form is for - Indicate any illness that will require special attention:
Emergency Contact(s)
Name of Contact #1
*
First Name
Last Name
Youth's Relationship to Contact #1
*
Contact #1 Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Name of Contact #2
First Name
Last Name
Youth's Relationship to Contact #2
Contact #2 Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Submit
Should be Empty: