St. Ignatius Martyr Catholic Church
Life Teen Youth Ministry Registration Form 2017-2018
Student Name: ______D.O.B.______Grade: _____
My student needs to be prepared for: Baptism Y __ N__ 1st CommunionY __ N__ Confirmation Y__ N__
Please indicate information if student has celebrated either of these Sacraments:
How many years has your child attended Religious Education or Youth Ministry Classes? _____ When?______
Does your child have any special needs? ______
Additional children can be added on the back of this page.
Parent/Guardian Information
Name:______
Address: ______
Phone Numbers: Home ______Work ______Cell ______
Email: ______Are you a registered parishioner here? Y ____ N ____
What is the preferred method of contact? Phone (choose one) – Home/Work/CellTextEmail
Who may we contact in case of emergency?
Name ______Relationship ______Phone: ______
Name ______Relationship ______Phone: ______
We are asking that each family contribute to our program this year in at least 1 of the following ways:
Please check at least 1 (or more) way(s) you would like to help us this year.
Help prepare, serve, and/or clean-up for 2 total meals for various Life Nights, Lock-Ins, or Retreats
Donate food, supplies, or monetarily towards various event meals
Volunteer to chaperone or drive for various events
For Staff Use Only $50 for each student, $30 for each additional student
Amount Paid ____Date Paid ____Circle One: Cash Credit Card Check#______Balance Due ______
Student Name: ______D.O.B.______Grade: _____
My student needs to be prepared for: Baptism? Y __ N__1st Communion? Y __ N__ Confirmation? Y__ N__
Please indicate information if student has celebrated either of these Sacraments:
How many years has your child attended Religious Education or Youth Ministry Classes? _____ When? ______
Does your child have any special needs? ______
Student Name: ______D.O.B.______Grade: _____
My student needs to be prepared for: Baptism? Y __ N__ 1st Communion? Y __ N__ Confirmation? Y__ N__
Please indicate information if student has celebrated either of these Sacraments:
How many years has your child attended Religious Education or Youth Ministry Classes? _____ When? ______
Does your child have any special needs? ______
Student Name: ______D.O.B.______Grade: _____
My student needs to be prepared for: Baptism? Y __ N__1st Communion? Y __ N__ Confirmation? Y__ N__
Please indicate information if student has celebrated either of these Sacraments:
How many years has your child attended Religious Education or Youth Ministry Classes? _____ When? ______
Does your child have any special needs? ______
Updated 5/17