EDGE

Student Registration Information

Registered with us before?*

This is my first time to register with St. Joseph Religious Ed
I am a returning student.

Name*

First Last

Gender*

Male
Female

Tshirt*

Which grade are you registering for?*

School*

Birthday*

Student Email

Mailing Address*

Street Address City State ZIP Code

Medical / Special Needs

Any Special Needs or Medical Conditions*

Yes
No

Describe any allergy, chronic illness, or other condition.*

Taking any Medications*

Yes
No

Please list medications and usage instructions.*

Sacramental Information

Baptism

Baptism Date

Church Name

City

State

First Reconciliation

First Reconciliation Date

Church Name

City

State

First Communion

First Communion Date

Church Name

City

State

PRIMARY CONTACT - Parent / Guardian Information

Child lives in a...*

1x Parent / Guardian Contact
2x Parent / Guardian Contact

Parent / Guardian Name*

First Last

Relationship to Student*

Phone*

Email*

Marital Status*

Religion*

Please describe any special family situations if applicable:

SECONDARY CONTACT - Parent / Guardian Information

Parent / Guardian Name*

First Last

Relationship to Student*

Phone*

Email*

Marital Status*

Religion*

Emergency Contact

Name*

First Last

Relationship to Student*

Phone*

Alternate Phone

Address*

Street Address City State ZIP Code

Model Release / Social Media

*

PERMISSION GRANTED: I hereby grant permission for my child to be photographed and/or videotaped during EDGE activities and events. I understand that my child may decline to be photographed and/or videotaped at any time. I further grant permission for the resulting photographs and/or videotaped footage to be edited, if necessary, and then published and/or broadcast for the purpose of promoting EDGE and/or youth programs at St. Joseph Catholic Church. I hereby grant permission for my child to be contacted via phone, SMS, and social media sites such as but not limited to parish websites, Facebook, Twitter, Vine, Instagram, Vimeo and YouTube for the purpose of promoting EDGE and/or youth programs at St. Joseph Catholic Church and/or to proclaim our faith that Christ is God, the Savior of humanity and of history, the one in whom all things find their fulfillment. I understand that my child may decline to be contacted at any time.
PERMISSION DENIED: I hereby decline to grant permission for my child to be photographed and/or videotaped during EDGE activities and events. I have instructed my child to decline to be photographed and/or videotaped at all times. I have further instructed my child to notify EDGE coordinators and/or Core Team / Volunteer Members that he/she may not be photographed and or videotaped under any circumstances. I hereby decline to grant permission for my child to be contacted via phone, SMS, and social media sites such as but not limited to parish websites, Facebook, Twitter, Vine, Instagram, Vimeo and YouTube for the purpose of promoting EDGE and/or youth programs at St. Joseph Catholic Church and/or to proclaim our faith that Christ is God, the Savior of humanity and of history, the one in whom all things find their fulfillment. I have instructed my child to decline to be contacted at all times. I have further instructed my child to notify EDGE coordinators and/or Core Team / Volunteer Members that he/she may not be contacted under any circumstances.

Registration Fees

EDGE Registration Fee*

EDGE Registration 6th-8th grade - $55

Total

$0.00

Payment Options

Payment Method*

Pay Now Online (Credit/Debit)
Mail Check
Drop Off Payment

Billing Information

Billing Name*

First Last

Billing Address*

Street Address Address Line 2 City State ZIP Code

Billing Email*

Billing Phone*

Credit Card*

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Total

$0.00

Submit Payment

Please DO NOT press register button more than once. Doing so may result in multiple billing.

Jr High youth group open to all 6th - 8th grade students

EDGE Registration 2016-2017

EDGE is a youth group ministry open to all 6th - 8th grade students.

Student Registration Information

Medical / Special Needs

Sacramental Information

Baptism

First Reconciliation

First Communion

PRIMARY CONTACT - Parent / Guardian Information

SECONDARY CONTACT - Parent / Guardian Information

Emergency Contact

Model Release / Social Media

Registration Fees

Payment Options

Billing Information

Submit Payment