REGISTRATION FORM

This field is for validation purposes and should be left unchanged.
Student Name(Required)
Address(Required)
MM slash DD slash YYYY
Parent Name(Required)
Emergency Contact(Required)
Please indicate if your child has received the following sacraments:*
Parents - would you like to: (please check all that apply)
May the Sacred Heart Youth Ministry team contact your child directly via phone, text or email?*(Required)
Photo Release: I give permission for Sacred Heart Cathedral to take photos or video of my child during Antioch and Antioch-related activities to use in SHC sponsored media (i.e. bulletin, videos, newsletters, parish Facebook, SHC website, etc.).(Required)