Register for Life Teen

Teen Name *

First

Last

Date of Birth (MM/DD/YYYY) *

Address *

Gender *

Teen Cell Phone

School Attending '21-'22 *

Grade *

Please check all that apply

Anyone specific you'd like to be in your Discipleship Group (small group)?

Anyone specific you'd like us to make sure is NOT in your Discipleship Group (small group)?

T-Shirt Size *

Allergies or learning-physical exceptionalities *

If none, put N/A

Symptoms/Treatments of Allergies or conditions

Guardian Name *

Relationship to child *

Cell Phone *

Do you receive text messages from our Remind App? *

If no, would you like to receive our Remind texts about events and information?

Email *

2nd Guardian Name (Or Emergency Contact) *

Secondary Cell phone *

I understand I need to print out the Image Waiver (link below) and return to my first attended event. *

http://lifeteen.ascensioncatholic.net/wp-content/uploads/2020/08/2020-2021-Edge-Registration.pdf

9th Grade Confirmation