Youth Ministry Registration

: SKD Youth Ministry Teen Info Sheet
: SY 2023-24

Today's Date (mm/dd/yyyy)
Teen's First and Last Name
Teen's Birth Date (mm/dd/yyyy)
Teen's Grade Level
Mailing Address
Home Phone Number (xxx-xxx-xxxx)
Teen's Cell Phone Number (xxx-xxx-xxxx)
Teen's E-mail Address (ex. name@domain.com)
Mom's First and Last Name
Mom's Cell Phone Number (xxx-xxx-xxxx)
Mom's E-mail Address ( ex. name@domain.com)
Dad's First and Last Name
Dad's Cell Phone Number (xxx-xxx-xxxx)
Dad's Email Address (ex. name@domain.com)
Names and Ages of Siblings
Names of other Members in the Household and Relationship (grandparent/s, step mom/dad, etc.)
Instagram
Snapchat
Twitter
Facebook
Other Social Media or Online Presence
Other Involvements (sports, clubs, orgs, etc.)
Best/Fastest Way to Reach You: Your Cell PhoneYour E-mailHome PhoneMom's Cell PhoneMom's E-mailDad's Cell PhoneDad's E-mailOther
Other way to reach you:
T-Shirt Size
Friend who invited you
Area I would like to focus in Youth Ministry this year. (First Choice)
Area I would life to focus in Youth Ministry this year. (Second Choice) Please select a different one.
Area I would life to focus in Youth Ministry this year (Third Choice) Please select a different one.

Church of St. Katharine Drexel