2018 Life Teen Registration

Please fill out the information below. If you have any questions please contact Judy Paffilas at (440)526-1686
Teen Info

 
Please select one option.
 
 
 
 
 
Education

Please select one option.
Please select one option.
Sacraments

Please select all that apply.
Please select all that apply.
Parent Info

 
 
 
 
 
 
 
 
Photo Release

As a participant in the Life Teen program, I hereby give St. Basil Church, and the Life Teen program my permission to use the above applicant’s likeness in photo or video form and his/her name in publicity, both within internal communication of the above-mentioned groups for use in communication pieces, and to area news media in all forms without limit as to time. I further release them from liability for what I might deem a misrepresentation of him/her by virtue of alterations, optical illusions, or faulty mechanical reproduction.
Please select all that apply.

Description

Please fill out the information below. If you have any questions please contact Judy Paffilas at (440)526-1686