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LIFETEEN REGISTRATION

Student Information
First Name  
Last Name  
Name Child Called
Date of Birth  
 (mm/dd/yyyy)
Parent's Name  
Home Tel #:
Address  

Father Work #:

City/State/ZIP  
,  
Mother Work #:
Student Email*
Student Cell

Parent E-Mail Address*

* Please supply both teen/parent email addresses if possible so that we can keep everyone informed of Lifeteen events.

Emergency Telephone  Numbers if Parent Cannot Be Reached

Telephone #1
Name
Relationship
Telephone #2
Name
Relationship
     
Sacraments
Has your child been Confirmed?
Confirmation Date
 
Location (Church, City, State)
 
 
Parent Volunteer Opportunities
There is always a place for you in St.Gerard Lifeteen. Please pray for Lifeteen and if God is calling you to assist, please answer. It is important for our children to have both male and female role models, so please, fathers as well as mothers feel free to join in the sharing of our faith with our teens.  
If God is calling you to participate as a parent volunteer, please call Jay Roueche at 954-1966.

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3049 LaFayette Road, Fort Oglethorpe, GA 30742 706-861-9410 stgeradmin@bellsouth.net