JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
United High School Youth Ministry - Registration and Waivers
THIS FORM CAN ONLY BE COMPLETED BY A PARENT/GUARDIAN
The first email address below must be a valid PARENT email address.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Parent Email Address
*
Your answer
Parish
*
Choose
St. Joseph Brookfield
St. Mary Bethel
St. Rose Newtown
Other
First Name of Teen/Minor
*
Your answer
Last Name of Teen/Minor
*
Your answer
Gender
*
Male
Female
Date of Birth
*
MM
/
DD
/
YYYY
Please select your teen's grade for the 2021-2022 academic year.
*
9
10
11
12
High School for 2021-2022 academic year
*
Your answer
Teen Cell Phone Number
*
Your answer
Parent Name and Cell Number
*
Your answer
Please provide us with any medical, dietary, or other information that you feel the United staff and volunteers should be aware of.
Your answer
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of St. Rose Church.
Report Abuse
Forms
