Youth Altar Servers' Registration Form

YOUTH ALTAR SERVER REGISTRATION FORM

* Indicates required field

Youth's Name *

First

Last

Youth's Sex *

Male Female

PARENT/GUARDIAN'S AUTHORIZATION

Parent/Guardian's Name *

First

Last

Parent's Email *

Parent's Phone Number *

Parent/Guardian Agreement *

By submitting my child's information (above) I, the parent/guardian of this child, hereby authorize St. Luke Roman Catholic Congregation, of Eureka, IL, to share this information with other members of the parish as it deems necessary for operation of its Altar Server ministry and to use a picture(s) or image(s) of my child on it's website to promote the Catholic Faith!

Submit This Youth Altar Server Registration Form