Youth Registration

Name: Wednesday Evening Eucharist
Start: 2023-03-29T17:30:00-06:00
End: 2023-03-29T18:00:00-06:00
Location: Saint Martins Chapel

First and Last Name*
First and Last Name
Preferred Name*
Preferred Name
Date of Birth*
Date of Birth
Month
Day
Year
Preferred Prounoun*
Preferred Prounoun
School Grade (2022/2023)*
School Grade (2022/2023)
Which school does participant attend? (2022/2023)*
Which school does participant attend? (2022/2023)
Participant Phone Number
Participant Phone Number
Occasionally, our youth ministry staff will contact youth by text, with your number included on the text, to check in, share updates about programs, or ask to lunch, coffee, or tea. Do we have permission to text the youth's phone number?*
Occasionally, our youth ministry staff will contact youth by text, with your number included on the text, to check in, share updates about programs, or ask to lunch, coffee, or tea. Do we have permission to text the youth's phone number?
- Yes
- No
All are welcome. Does the youth participant have special needs we should know about, so that we can provide the safest and most comfortable environment possible?*
All are welcome. Does the youth participant have special needs we should know about, so that we can provide the safest and most comfortable environment possible?
Is there anything else you would like us to know about the participant?
Is there anything else you would like us to know about the participant?
Please list any allergies, dietary restrictions, or medical needs your child has.*
Please list any allergies, dietary restrictions, or medical needs your child has; if none, please write 'none'.

Family Information
If you have already filled out family information for one child/youth participant, you do not have to fill this section out again. If you have not yet given us this information, please fill out for at least one youth participant.
Home Address*
Home Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Are you members of Saint John's Cathedral? (For information only – all are welcome!)*
Are you members of Saint John's Cathedral? (For information only – all are welcome!)
- Yes
- No
Saint John's requests the right to take photographs/videos of program participants for lawful purposes, including publicity, internal news reporting, and web content.
Saint John's requests the right to take photographs/videos of program participants for lawful purposes, including publicity, internal news reporting, and web content.
- Yes, I give permission to use my child's image on the Saint John's website, in-house promotions, and social media.
- No, I do not give permission to use my child's image anywhere.

Parent 1
First and Last Name*
First and Last Name
Cell Phone Number*
Cell Phone Number Please leave cell phone on during formation in case of emergency.
Email Address*
Email Address
Would you like to receive The Family Voice weekly e-newsletter?
- Yes
- No, I already receive The Family Voice.
Parent 2
First and Last Name
First and Last Name
Cell Phone Number
Cell Phone Number Please leave cell phone on during formation in case of emergency.
Email Address
Email Address

Family Information