Youth Group Registration
(Grades 7-12)

Registering for *
Birthdate *
Mother's Cell
Mother's Cell
Father's Cell
Father's Cell
Youth Contact Information (From time to time we will send messages/emails as reminders and/or to communicate with members of the youth group. There will always be at least 2 adults involved in the messaging/emails)
Youth's Cell Phone
Youth's Cell Phone
I would like to be included on all youth communication (email and messages)
Does your child have a medical condition, food allergies, or behavioral problems? *
Please indicate below any special circumstances regarding your child or family. If allergy is potentially life threatening, please meet with the Director to discuss.
Name | Phone | Relationship
Name | Phone
In the event that a parent/guardian cannot be reached, I hereby give my consent to St. Charles Borromeo Catholic Church to contact the physician listed above, and, if necessary, transport my child to a clinic or hospital *
I hereby give St. Charles Borromeo Catholic Church permission to publish pictures of my child on the parish website, social media, and/or parish publications. (Please note: No names will be included with pictures).
I am interested in helping as a small group facilitator for Youth Group *

If you are an adult that would like to help out please fill out the form below!