WOVEN 2025-2026 Registration Form

WOVEN High School Ministry

2025-2026
Student Registration
Student Information
Student Name*

First NameMiddle NameLast Name
Date of Birth*

MonthDayYear
Age*
Gender*
Grade in School 2025-2026*
High School Attending*
Please list any medical conditions, allergies, or special needs for this teen*
I give permission to The Holy Name of Jesus to publish photos of my child in church related social media.*
Student email
Student Cell Phone

Area CodePhone Number
Student Sacraments
YesNo
YesNo
Student 2 Information
Student #2 Information
Student Name

First NameMiddle NameLast Name
Date of Birth

MonthDayYear
Age
Gender
Grade in School 2025-2026
High School Attending
Please list any medical conditions, allergies, or special needs for this teen
I give permission to The Holy Name of Jesus to publish photos of my child in church related social media.
Student email
example@example.com
Student Cell Phone

Area CodePhone Number
Student Sacraments
YesNo
YesNo
Parent/Guardian Information
Mother's Information
Mother's Name*

First NameLast Name
Mother's Maiden Name*
Phone Number*

Area CodePhone Number
E-mail Address*
example@example.com
Fathers's Information
Father's Name*

First NameLast Name
Phone Number*

Area CodePhone Number
E-mail Address*
example@example.com
Address (where child primarily resides)*

Street Address

Street Address Line 2

CityState

Zip Code
Primary language spoken in the home*
Are you registered parishioners at The Holy Name of Jesus?*
Emergency Contact (If Parent/Guardian cannot be reached)*
Relationship to Student*
Emergency Phone Number*

Area CodePhone Number
Today's Date*

MonthDayYear
Date
Should be Empty:

WOVEN High School Ministry

Student Registration

Student 2 Information

Parent/Guardian Information