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Lifeteen Registration

- Lifeteen/Youth Ministry

REGISTRATION FEE: $40
Classes Are delayed due to hurricane damage to our building.

There are Two Options Available this year for 9-10th Instruction
Lifeteen Registration Form
The maximum number of form submissions has been reached. This form is currently not available.
- Student Information:
  
  Student NAME: REQUIRED Please fill out this field. Please enter valid data.
  
  Class Instruction Option REQUIRED Please fill out this field.
  
  Grade REQUIRED Please fill out this field.
  
  Address REQUIRED Please fill out this field. Please enter valid data.
  
  E-mail: Please enter valid data.
  
  Birthday REQUIRED Please fill out this field. Please enter valid data.
  
  Teen's Cell Phone Please enter valid data.
- Sacramental Information:
  
  Completed Sacraments: Baptism Eucharist Penance Sacramental Prep NEEDED
  
  Church & City of Baptism REQUIRED Please fill out this field. Please enter valid data.
- Special Requests:
  
  Special Needs (medical, learning, or physical):
  
  Is there a certain small group leader you'd like to request? Please enter valid data.
  
  A Certain friend you'd like in your small group? Or any other group requests? Please enter valid data.
  
  Any other requests for your small group ? Please enter valid data.
  
  Do you need to pay with a payment plan or Need financial assistance? If yes request below Please enter valid data.
- Parent/Guardian Information:
  
  Father's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's name: REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Maiden Name: REQUIRED Please fill out this field. Please enter valid data.
  
  Parent/Guardian Cell Phone REQUIRED Please fill out this field. Please enter valid data.
  
  Phone: Please enter valid data.
- Anything else we should know to better serve your teen?
- I hereby give permission to photograph my child for lifeteen events, church website, & bulletin purposes?
  Photographs may be used to put on St. Theodore's Lifeteen Facebook page, church website, & bulletin
  Yes No
Submit

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St. Theodore Catholic Church

337-855-6662

Lifeteen Registration

There are Two Options Available this year for 9-10th Instruction

Lifeteen Registration Form