Youth Group Sign-Up

- Life Long Learning

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- There is no fee to join the Youth Group.
- FAMILY INFORMATION
- Family Last Name REQUIRED Please fill out this field. Please enter valid data.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Address REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Emergency Contact (other than parent) REQUIRED Please fill out this field. Please enter valid data.
- Emergency Contact Phone REQUIRED Please fill out this field. Please enter valid data.
- Emergency Contact Relationship REQUIRED Please fill out this field. Please enter valid data.
- Child Resides With..... REQUIRED Please fill out this field.
- Is your family registered with St. Michael Parish REQUIRED Yes No Please fill out this field.
- Is your family registered with another Catholic Parish REQUIRED Yes No Please fill out this field.
- If yes, please let us know which parish: Please enter valid data.
- FATHER INFORMATION
  Complete address if different than above
- Name Please enter valid data.
- Address Please enter valid data.
- City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Home Phone Please enter valid data.
- Cell phone Please enter valid data.
- Are you Catholic?
- MOTHER INFORMATION
  Complete address if different from Family Information
- Name Please enter valid data.
- Address Please enter valid data.
- City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Home Phone Please enter valid data.
- Cell phone Please enter valid data.
- Are you Catholic?
- Number of Children Coming to Youth Group REQUIRED Please fill out this field.
  
  Child 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  School Attending REQUIRED Please fill out this field. Please enter valid data.
  
  Birthday (MM/DD/YY) REQUIRED Please fill out this field. Please enter valid data.
  
  Grade Level REQUIRED Please fill out this field.
  
  Email Please enter valid data.
  
  Cell Phone Please enter valid data.
  
  Allergic Reactions (please list all known allergies and type of reaction): Please enter valid data.
  
  Medical Conditions (physical, psychological, developmental) we should be aware of: Please enter valid data.
  
  Prescription Medications they currently take: Please enter valid data.
  
  Child 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  School Attending REQUIRED Please fill out this field. Please enter valid data.
  
  Birthday (MM/DD/YY) REQUIRED Please fill out this field. Please enter valid data.
  
  Grade Level REQUIRED Please fill out this field.
  
  Email Please enter valid data.
  
  Cell Phone Please enter valid data.
  
  Allergic Reactions (please list all known allergies and type of reaction): Please enter valid data.
  
  Medical Conditions (physical, psychological, developmental) we should be aware of: Please enter valid data.
  
  Prescription Medications they currently take: Please enter valid data.
  
  Child 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  School Attending REQUIRED Please fill out this field. Please enter valid data.
  
  Birthday (MM/DD/YY) REQUIRED Please fill out this field. Please enter valid data.
  
  Grade Level REQUIRED Please fill out this field.
  
  Email Please enter valid data.
  
  Cell Phone Please enter valid data.
  
  Allergic Reactions (please list all known allergies and type of reaction): Please enter valid data.
  
  Medical Conditions (physical, psychological, developmental) we should be aware of: Please enter valid data.
  
  Prescription Medications they currently take: Please enter valid data.
  
  Child 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  School Attending REQUIRED Please fill out this field. Please enter valid data.
  
  Birthday (MM/DD/YY) REQUIRED Please fill out this field. Please enter valid data.
  
  Grade Level REQUIRED Please fill out this field.
  
  Email Please enter valid data.
  
  Cell Phone Please enter valid data.
  
  Allergic Reactions (please list all known allergies and type of reaction): Please enter valid data.
  
  Medical Conditions (physical, psychological, developmental) we should be aware of: Please enter valid data.
  
  Prescription Medications they currently take: Please enter valid data.
  
  Child 5
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  School Attending REQUIRED Please fill out this field. Please enter valid data.
  
  Birthday (MM/DD/YY) REQUIRED Please fill out this field. Please enter valid data.
  
  Grade Level REQUIRED Please fill out this field.
  
  Email Please enter valid data.
  
  Cell Phone Please enter valid data.
  
  Allergic Reactions (please list all known allergies and type of reaction): Please enter valid data.
  
  Medical Conditions (physical, psychological, developmental) we should be aware of: Please enter valid data.
  
  Prescription Medications they currently take: Please enter valid data.
  
  Child 6
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  School Attending REQUIRED Please fill out this field. Please enter valid data.
  
  Birthday (MM/DD/YY) REQUIRED Please fill out this field. Please enter valid data.
  
  Grade Level REQUIRED Please fill out this field.
  
  Email Please enter valid data.
  
  Cell Phone Please enter valid data.
  
  Allergic Reactions (please list all known allergies and type of reaction): Please enter valid data.
  
  Medical Conditions (physical, psychological, developmental) we should be aware of: Please enter valid data.
  
  Prescription Medications they currently take: Please enter valid data.
- Would you like more information regarding: The Sacrament of Confirmation (8-12th grades) Middle School Faith Formation Classes (7-8th grades)
- Would you like more information about adult volunteer opportunities for our Youth Group? (Virtus & background checks required.) Adult Mentor for Youth-training to be provided Assistant to Youth Leaders (for youth group nights, service outings, and special event retreats. Assistants will help serve meals, clean up, help with transportation, and organize other adult volunteers.)
- Is there any other information you would like us to know (scheduling concerns, etc.)? Please enter valid data.
- PHOTO RELEASE INFORMATION
  Our Policy: At our youth offerings we sometimes take pictures for publicity or to share with parishioners and parents. They may be displayed on our bulletin boards, print publications like our bulletin and flyers, and/or online (our website and our Facebook page).
  
  If you do not wish to have pictures of your child(ren) published in any of the above ways, please check the box below.
- I Deny Permission I deny permission to St. Michael Parish to publish a picture of my child(ren) in any of the above ways
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