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AWAKEN Youth Registration 2020-2021

- Youth Ministry
  - Youth Formation & Outreach
    
    High School Youth Ministry
    
    Youth Registration
    
    Permission Form
    
    CYO Sports
    Scouting
  - Young Adult Ministry
    
    Young Adult Events
    Around the Diocese

The maximum number of form submissions has been reached. This form is currently not available.
- Please fill out the information below about the high school youth who will be attending the AWAKEN program this academic year.
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Gender REQUIRED Please fill out this field.
- Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Email REQUIRED Please fill out this field. Please enter valid data.
- Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- School Attending REQUIRED Please fill out this field.
- If you selected OTHER for school attending please specify below Please enter valid data.
- Grade REQUIRED Please fill out this field.
- Known allergies, allergies to medicine, or other medical conditions which may affect involvement in youth activities. REQUIRED Please fill out this field.
- Please fill out the parent/guardian information below.
- Mother's Information
  
  Mother's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Street Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Mother's Cell Phone REQUIRED Please fill out this field. Please enter a phone number.
  
  Mother's Work Phone Please enter a phone number.
  
  Mother's Email REQUIRED Please fill out this field. Please enter an email address.
- Father's Information
  
  Father's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Street Address Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  Father's Cell Phone REQUIRED Please fill out this field. Please enter a phone number.
  
  Father's Work Phone Please enter a phone number.
  
  Father's Email REQUIRED Please fill out this field. Please enter valid data.
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St. Louis Catholic Church

Alexandria, VA

AWAKEN Youth Registration 2020-2021