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St. Bernard's Youth Group Registration Form
EDGE NIGHTS (middle school) meet Monday at 6:00 pm
LIFE NIGHTS (high school) meet Wednesday at 6:00 pm
Both meetings take place at "the corner house" behind the church, unless otherwise advertised
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Email
*
Your email
Participant First and Last Name
*
Your answer
Family Address
*
Your answer
Participant Birth Date
*
MM
/
DD
/
YYYY
Gender
*
Male
Female
Required
Participant Age
*
Your answer
School name
*
Your answer
Participant Grade
*
Your answer
T-shirt size
*
XS
S
M
L
XL
XXL
Participant email
*
Your answer
Participant cell
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Your answer
Parent 1 - First and Last Name
*
Your answer
Parent 1 - cell phone number
*
Your answer
Parent 1 - email
*
Your answer
Emergency Contact Name (other than parent above)
*
Your answer
Emergency Contact Number (other than parent above)
*
Your answer
Alternate email address
Your answer
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