Teen Registration
TEEN INFORMATION:
Name
*
First Name
Last Name
Grade (for 2025-26 school year)
Please Select
Freshman
Sophomore
Junior
Senior
Grad
Name of School
*
Shirt size
*
Please Select
S
M
L
XL
2XL
3XL
Family members attending Thursday Family night dinner (after 5pm mass)
*
PARENT/GUARDIAN INFORMATION:
Parent/Guardian Name
*
First Name
Last Name
Relationship
Emergency Contact (if different than Parent/Guardian)
*
Phone Number
*
E-mail
*
example@example.com
MEDICAL INFORMATION
Physician Name
*
First Name
Last Name
Phone Number
*
Health Insurance provider
*
Please upload image of your Health insurance Card
*
Medical Concerns or medications taken (if none, put N/A)
*
General Allergies (if none, put N/A)
*
Food Allergies (If yes, then list allergy in the next field and provide picture of person with allergy)
*
Please Select
Yes
No
Food Allergy
Picture of person with allergy
Guardian Angel
Favorite Candy?
*
Favorite Color?
*
Favorite Sport/Team?
*
Favorite TV/Movie/Book?
*
Favorite Restaurant?
*
Things you collect?
*
What are some hobbies of yours?
*
Favorite Music/Band?
*
Who is your patron or favorite Saint?
*
What are some other interests you have?
*
Submit Form
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