Youth Ministry Group Registration

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St. Elizabeth of Hungary
Francis Serpico, Youth Minister

Youth Information

First Name: *

Last Name: *

Date of Birth *

YYYY

Address *

City *

Zip Code *

Telephone Number *

Email *

Current Grade *

Name of school you attend *

Activities you are involved in *

Youth Declaration: I understand that by participating in St. Elizabeth Youth Ministry Group, I am representing myself, my family, my community, my church, and my God, and will conduct myself as a Christian. I understand that if I don't I may be asked to rethink my involvement in the Youth Ministry Group. *

I have read the Youth Declaration and full understand this is my agreement in following the expectations.

Please list any allergies, special needs, or medical needs below:

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