San Jose Youth Ministry Registration - San Jose Catholic Church

Youth Group Registration

Thank you for your interest in our Youth Ministry program here at San Jose. Please complete the registration form to receive all the latest news and activities for our Youth Group!

Date*
Today's Date
MM slash DD slash YYYY
Name*
First Last
Date of Birth*
Please enter your date of birth
MM slash DD slash YYYY
Address - include Apt. Number*
Street Address Apartment/Unit Number City State ZIP Code
Cell Phone*
Youth's cell phone number
Email*
Youth's email
Enter Email Confirm Email
School*
What school do you attend
Grade*
- 6th Grade
- 7th Grade
- 8th Grade
Grade*
- 9th Grade
- 10th Grade
- 11th Grade
- 12th Grade
Family Information
Mother's Name*
Name of Parent or Guardian responsible for Youth Registrant
Parent/Guardian First Name Parent/Guardian Last Name
Phone*
Email*
Father's Name*
Parent/Guardian First Name Parent/Guardian Last Name
Phone
Email

Youth Group Registration

Family Information