St. Anthony: LIFE TEEN REGISTRATION FORM

We would like to welcome you to our St. Anthony Life Teen family!

This year we are still hoping to have face-to-face youth life nights twice a month, and are looking to have our meetings in the St. Anthony parking lot near the image of Mother Mary.

If you have any questions or concerns, please contact Hector Martinez Jr.
at 361-424-2663.

TEEN INFORMATION

Name

First Name*

Last Name*

Date of Birth

Required* //

Phone

Required* --

Name of High School Attending

Required*

Grade Level
Required*

	9th
	10th
	11th
	12th

What Sacraments have you received?
Required*

	Received All Sacraments listed below
	Baptism
	Confession
	Communion
	Confirmation

T-shirt size
Required*

	XS
	S
	M
	L
	XL
	XXL

PARENT/GUARDIAN INFORMATION

Best Family E-mail
Parent/Guardian Names	Required*
Parent/Guardian Address	(Street/PO Box, City, State, Zip)*
Parent/Guardian Cell Phone Number	Required*
CHILD'S ALLERGIES (please list all allergies or N/A)	Required*
LIST MEDICATIONS YOUR CHILD TAKES REGULARLY	(Please list or type N/A)*
Do you give Life Teen core members permission to administer over-the counter medications to your child?	(Tylenol, Imodium, etc.) *
Did your child attend Faith Formation last year?	(Religious Ed-CCD, Life Teen, Edge, etc.) *
Is your child allowed to drive to and from Life Teen Events?	Required*
Would you like to help volunteer for any Life Teen events?	Required*
Emergency Contact Person and Cell Phone #	Required*
Family Doctor's Name and Phone #

For Security Purposes

Parent/Guardian Signature: I acknowledge that as the parent/guardian, this information will be submitted to the Parish for use in Registration
Required*

	Yes
	No

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LIFE TEEN REGISTRATION FORM

2020-2021

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