REGISTRATION FORM - St. Joan of Arc Catholic Church

REGISTRATION FORM
St. Joan of Arc
High School Youth Group
TEEN INFO
Name: _________________________________________________________________
Birth Date:_____/_____/_________ M____ F____ Grade: ______________
High School:______________________________________
T-Shirt Size: __________
Address:_______________________________________________________________
Home #:____________________________ Cell #: ____________________________
Teen email: ____________________________________________________________
GUARDIAN INFO
Mother’s Name_________________________________________________________
Cell #: _________________________________________________________________
Email: _________________________________________________________________
Father’s Name__________________________________________________________
Cell #: _________________________________________________________________
Email: _________________________________________________________________
EMERGENCY CONTACT
Name: _________________________________________________________________
Relationship to Teen____________________________________________________
Phone #: _______________________________________________________________
As a member of the St. Joan of Arc High School Youth Group I promise to be
respectful to all in attendance, to be responsible for any guests I bring along, and
to remain with the group at all times. I understand that I am an important part of
this parish community and that my active participation is a way of showing I care
about and respect all those involved. My parent and I understand these
guidelines and realize that, if violated, actions deemed necessary by the Youth
Minister will be taken which may include parental contact.
Teen Signature _________________________________________________________
Parent Signature ________________________________________________________
PHOTOGRAPHY/VIDEOGRAPHY WAIVER
I understand that my child may be photographed or recorded on video during the
course of youth ministry events. By initialing below I provide consent for their
image to be used in print, electronic, or video form for the promotional purpose of
youth group activities.
Initials of Parent/Guardian: ___________
$25
Registration Fee
paid _________
SUNDAY NIGHT DINNERS
My family and I would be willing to provide a small meal or snacks for the Youth
Group Meetings on the following Sunday evenings:

Please mark an “X” on your available dates:
Sep 16 _________________________
Sep 23 _________________________
Sep 20 _________________________
Oct 7 _________________________
Oct14 _________________________
Oct 21 _________________________
Oct 28 _________________________
Nov 4 _________________________
Nov 11_________________________
Nov 18_________________________
Dec 2 _________________________
Dec 9 _________________________
Dec 16 _________________________
Jan 13 _________________________
Jan 27 _________________________
Feb 3 _________________________
Feb 17 _________________________
Feb 24 _________________________
Mar 3 _________________________
Mar 10_________________________
Mar 17_________________________
Apr 7 _________________________
Apr 14 _________________________
Apr 21 _________________________
Apr 28 _________________________
May 5 _________________________
May 19_________________________
June 2 _________________________
*Katherine will create a schedule based on everyone’s availability
and then contact you when it is ready.