Teen Pathways Registration Form 2013-2014

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Please fill in the following information for registration in the Teen Pathways Program. Remember Teen Pathways is a TWO year Confirmation preparation and Youth Ministry Program.

Cost for the program is 45$ a teen.

ALL PAYMENTS SHOULD BE SENT TO THE PARISH OFFICE, or BROUGHT TO THE FIRST SESSION.
See you in the Fall!

Teen's Parish *

Teen's Grade in Fall of 2013 *

Teen's First Name *

Teen's Last Name *

Parent's/Guardians Names (first, last) *

Street Address, City, State and Zip *

Teen's School *

Family Contact Number *

Best number to reach you a night of a session

Parent's Email Address *

All communication and information regarding the Teen Pathways program will be sent using email. Please add as many as you would like to be contacted. MAKE SURE EACH EMAIL IS SEPARATED BY A COMMA (,)

Emergency Contact and Number *

Please add name and phone number of a emergency contact in case you cannot be reached.

Allergies or Medication Concerns

Please list any medical, allergy or other concerns that you would like us to know about here.

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