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2022 Wisconsin Catholic Youth Rally
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Student First Name
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Your answer
Student Last Name
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Your answer
Grade for 2021-2022 School Year
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6
7
8
9
10
11
12
School for 2021-2022 School Year
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Your answer
Parent/Guardian 1 Name
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Your answer
Parent/Guardian 1 Phone Number
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Your answer
Parent/Guardian 1 Email
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Your answer
Parent/Guardian 2 Name
Your answer
Parent/Guardian 2 Phone Number
Your answer
Parent/Guardian 2 Email
Your answer
Student Medical Conditions/Dietary Restrictions
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Your answer
Student Medicines
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Your answer
Emergency Contact Name (other than parent/guardian)
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Your answer
Emergency Contact Phone Number (other than parent/guardian)
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Your answer
Payment
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Faith Direct (link on parish website and on confirmation page of this form)
Check (made payable to Divine Mercy Parish with Wisconsin Catholic Youth Rally in memo)
Cash
Any comments or questions
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