Register for Edge, Life Teen & Confirmation

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FAMILY INFORMATION
- PRIMARY PARENT
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- Email REQUIRED Please fill out this field. Please enter an email address.
- ADDITIONAL PARENT
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Are you registered parishioners at St. Alphonsus? REQUIRED Please fill out this field.
- Parish of Registration Please enter valid data.
- Become a Member I would like information on joining St. Alphonsus Parish.
EMERGENCY CONTACT
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Relation to Child REQUIRED Please fill out this field. Please enter valid data.
- Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- Number of Children REQUIRED Please fill out this field.
- Child 1
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  - 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.
  - Cell Phone Number Please enter a phone number.
  - Email Please enter an email address.
  - Grade REQUIRED Please fill out this field.
  - Program REQUIRED Please fill out this field.
  - Confirmation registration includes Sunday evening Life Teen nights. Should we place your child in a Life Teen Small Group and plan on them attending? Yes No
  - Does your child have allergies? REQUIRED Please fill out this field.
  - Please list allergies and/or any other medical concerns that would help us minister to your teen, such as anxiety, asthma, etc. Please enter valid data.
  - Small Groups
    
    The following questions will help us form small groups for Edge Nights and Life Nights.
  - What school does this student attend? REQUIRED Please fill out this field. Please enter valid data.
  - What activities does your child participate in? Please enter valid data.
  - As we form Small Groups to walk with our students, we will do our best to meet them where they are. Will their activities or sports often conflict with Edge or Life Nights? REQUIRED Please fill out this field.
  - In an effort to make your teen feel comfortable in a small group from the start, please list two friends they'd like to be grouped with. Please enter valid data.
  - Is there any other information we should know when placing your student in a small group? Please enter valid data.
  - What do you hope your child will take away from youth ministry? Please enter valid data.
- Child 2
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  - 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.
  - Cell Phone Number Please enter a phone number.
  - Email Please enter an email address.
  - Grade REQUIRED Please fill out this field.
  - Program REQUIRED Please fill out this field.
  - Confirmation registration includes Sunday evening Life Teen nights. Should we place your child in a Life Teen Small Group and plan on them attending? Yes No
  - Does your child have allergies? REQUIRED Please fill out this field.
  - Please list allergies and/or any other medical concerns that would help us minister to your teen, such as anxiety, asthma, etc. Please enter valid data.
  - Small Groups
    
    The following questions will help us form small groups for Edge Nights and Life Nights.
  - What school does this student attend? REQUIRED Please fill out this field. Please enter valid data.
  - What activities does your child participate in? Please enter valid data.
  - As we form Small Groups to walk with our students, we will do our best to meet them where they are. Will their activities or sports often conflict with Edge or Life Nights? REQUIRED Please fill out this field.
  - In an effort to make your teen feel comfortable in a small group from the start, please list two friends they'd like to be grouped with. Please enter valid data.
  - Is there any other information we should know when placing your student in a small group? Please enter valid data.
  - What do you hope your child will take away from youth ministry? Please enter valid data.
- Child 3
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  - 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.
  - Cell Phone Number Please enter a phone number.
  - Email Please enter an email address.
  - Grade REQUIRED Please fill out this field.
  - Program REQUIRED Please fill out this field.
  - Confirmation registration includes Sunday evening Life Teen nights. Should we place your child in a Life Teen Small Group and plan on them attending? Yes No
  - Does your child have allergies? REQUIRED Please fill out this field.
  - Please list allergies and/or any other medical concerns that would help us minister to your teen, such as anxiety, asthma, etc. Please enter valid data.
  - Small Groups
    
    The following questions will help us form small groups for Edge Nights and Life Nights.
  - What school does this student attend? REQUIRED Please fill out this field. Please enter valid data.
  - What activities does your child participate in? Please enter valid data.
  - As we form Small Groups to walk with our students, we will do our best to meet them where they are. Will their activities or sports often conflict with Edge or Life Nights? REQUIRED Please fill out this field.
  - In an effort to make your teen feel comfortable in a small group from the start, please list two friends they'd like to be grouped with. Please enter valid data.
  - Is there any other information we should know when placing your student in a small group? Please enter valid data.
  - What do you hope your child will take away from youth ministry? Please enter valid data.
PARISH MEDIA & COMMUNICATIONS
- PARISH MEDIA
- We love to post pictures of the teen activities (Confirmation, retreat groups, etc) in our parish bulletin and social media pages to share what we are doing and promote our ministries.
- May we post or print pictures of your child(ren)? REQUIRED Please fill out this field.
- COMMUNICATION RELEASE
- In high school youth ministry we emphasize teens taking ownership of their faith. We would like to share opportunities with them through email and text messaging to help them in this journey (particularly in newsletters via email and the GroupMe text messaging app).
  Please note that two Safe Environment-trained adults will always be included in any communication with minors.
- Please select all that apply... REQUIRED Yes, you may contact my teen(s) via text. Yes, you may contact my teen(s) via email. Yes, you may contact my teen(s) via text and email, but only if I am included in the group and copied on the message. No, you may not contact my teen(s) directly. Please send any communications to the primary parent who will share the information with my child. Please fill out this field.
PAYMENT INFORMATION
Payment Options REQUIRED Please fill out this field.
- Number of Children REQUIRED Please fill out this field.
- Child 1
  - Youth Ministry Registration Payment
    150 – Confirmation (Grade 10 - includes Sunday Life Nights)
    60 – Edge (Grades 6, 7, 8)
    75 – Life Teen (Grades 9, 10, 11, 12 - includes dinner at Sunday Life Nights)
- Child 2
  - Youth Ministry Registration Payment
    150 – Confirmation (Grade 10 - includes Sunday Life Nights)
    60 – Edge (Grades 6, 7, 8)
    75 – Life Teen (Grades 9, 10, 11, 12 - includes dinner at Sunday Life Nights)
- Child 3
  - Youth Ministry Registration Payment
    150 – Confirmation (Grade 10 - includes Sunday Life Nights)
    60 – Edge (Grades 6, 7, 8)
    75 – Life Teen (Grades 9, 10, 11, 12 - includes dinner at Sunday Life Nights)
If you have any questions, please email youthministry@zionsvillecatholic.com.

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Register for Edge, Life Teen & Confirmation

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