LifeTeen Registration 2022-2023
As a Eucharist-centered movement within the Roman Catholic Church, Life Teen leads teenagers and their families into a deeper relationship with Jesus Christ and His Church. With the Blessed Virgin Mary as our intercessor and guide, Life Teen seeks to unleash the fullness of the Sacramental power present within the young Church.

LifeTeen is a high school group that meets regularly all year long. During the academic year teens meet with their small groups twice a month, and meet altogether every 3rd Sunday of the month from 5pm-8:30pm (Attending the 6pm Mass, Fellowship Dinner, and Eucharistic Adoration).

We encourage all of our teens at our Parish to register to be a part of this wonderful program!
(No Registration Fee!)
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Faith Formation Director: Anna Vierra | avierra@olassumption.net | 209-634-2222
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Teen's Last Name *
Teen's First Name *
Address (Street, City, State, Zipcode) *
Ex. 111 Old Town Rd. Turlock, CA 95380
Teen's Date of Birth *
MM
/
DD
/
YYYY
Grade (This Fall) *
High School (This Fall) *
Sex *
Primary Email *
Please provide the email that is checked on a regular basis
Teen's Cell Phone # *
Mother/Guardian Name *
Mother/Guardian's Cell Phone *
Father/Guardian Name *
Father/Guardian's Cell Phone *
Best way to contact teen for reminders and schedule changes? *
List of any medications your teen is taking *
List of any medical conditions physical or mental, allergies, and physical restrictions *
Dietary Restrictions *
Required
T-Shirt Size (Adult) *
Medical Insurance *
Ex. Kaiser Permanente
Policy Number *
Name of person other than parents to contact in case of emergency: *
Relationship to Teen *
Ex. Aunt
Phone Number of Emergency Contact *
Each Teen in our Parish will be assigned to a small group consisted of teens of the same sex and roughly similar ages. Small groups will meet about twice a month for an hour. Please choose the day/time of availability for your Fall 2022 schedule (Please choose all that apply) *
Required
Will your family be able to bring food/snacks/drinks (typically enough for 25-30 people) to one (or more) of our monthly LifeNight dinners? *
Will your family be able to bring donuts (typically enough for 20 people) after the Devotions to the Immaculate Heart of Mary on one of the 1st Saturdays of the Month? *
*The 1st Saturday Devotion is in honor of the Immaculate Heart of Mary that is celebrated every 1st Saturday of the Month starting at 9am with Adoration and confession followed by the 10am Bilingual Mass. Starting this fall (September), LifeTeen will host a small little fellowship with donuts outside the small church after the 10am Bilingual Mass on 1st Saturdays and we hope to see you there!*
Do you know of any friend or family member who may be interested in joining LifeTeen? *
Please provide name & contact information if applicable
Do you know of any friend or family member who is over 21 y/o who may be interested in becoming a Core Team Member? *
Please provide name & contact information if applicable
Do you know anyone who would be interested in volunteering for LifeTeen? *
Please provide name & contact information, along with a description of volunteer service interest if applicable
Media Release
Permission to Use Photograph Subject: LifeTeen Program
Location: Parish & other locations of LifeTeen events

I grant to Our Lady of the Assumption its representatives and employees the right to take photographs and video of me and my property in connection with the LifeTeen Program. I authorize Our Lady of the Assumption, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Our Lady of the Assumption may use such photographs and video of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content.
I have read, understood, and agree to the Media Release permissions above. *
Liability Waivers
Some LifeTeen events will take place off Church Campus and requires parents to sign a Liability Waver for their child to attend and participate. In these cases, the Faith Formation Director or Youth Minister will either give them to the teen in person, and/or email the Liability Waiver to parents to send back signed.
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