Youth Group Registration

Date of Registration

Student's Information

Name of the Youth(Required)

First Last

Preferred Name(Required)

Date of Birth(Required)

Gender(Required)

Female

Male

T-Shirt Size(Required)

Student's Email(Required)

Student's Phone (Optional)

Sacramental Life(Required)

Baptism

First Holy Communion

Confirmation

Grade entering in 2024-2025(Required)

Name of the School the Youth is attending(Required)

Youth Resides with:(Required)

Mother

Father

Both Parents

Other

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parents' or Legal Guardian's Information

Father / Guardian(Required)

First Last

Address (if different)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Mother / Guardian(Required)

First Last

Home Phone(Required)

Email(Required)

Address (if different)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Emergency Contact Information

Name(Required)

First Last

Home Phone(Required)

Cell Phone(Required)

Relationship(Required)

Image Disclosure Consent

Permission for Image Disclosure of Child.(Required)

Yes, I would like to authorize.

No, I would not like to authorize

Permission for Image Disclosure

Yes, I DO authorize the Faith Formation department of St. Catherine of Siena Parish, in Kissimmee, FL to take photos, videos or any type of recording of my child to be used in the Parish Bulletin, Parish Website, or any other Parish Form. I waive from any claims, and release all the staff members, volunteers of St. Catherine of Siena Catholic Church in Kissimmee, FL, and/or the Diocese of Orlando, weather former, future, or current, from any and all claims, actions, cause of actions, suits, costs, expenses, liabilities, or/and damages.

Youth Group Registration

Youth Group Ministry 2024-2025

Student's Information

Parents' or Legal Guardian's Information

Emergency Contact Information

Image Disclosure Consent