Youth Ministry | Edge Registration - Nativity Catholic Church

How many middle schoolers are you registering for Edge?

Date of Birth(Required)

Student 1 Cell Phone(Required)

Student 1 Email(Required)

Name of Middle School(Required)

Health Insurance Company(Required)

Policy Number(Required)

Diocesan Requirement in case of an emergency/ please provide accurate policy number for health insurance. This information will be kept confidential.

Please list any medical conditions or allergies that may affect your child's involvement in this program.

Comments

Please share anything you'd like us to know about your child and their participation in this program.

Date of Birth(Required)

Student 2 Cell Phone(Required)

Student 2 Email(Required)

Name of Middle School(Required)

Health Insurance Company(Required)

Policy Number(Required)

Diocesan Requirement in case of an emergency/ please provide accurate policy number for health insurance. This information will be kept confidential.

Please list any medical conditions or allergies that may affect your child's involvement in this program.

Comments

Please share anything you'd like us to know about your child and their participation in this program.

Date of Birth(Required)

Student 3 Cell Phone(Required)

Student 3 Email(Required)

Name of Middle School(Required)

Health Insurance Company(Required)

Policy Number(Required)

Diocesan Requirement in case of an emergency/ please provide accurate policy number for health insurance. This information will be kept confidential.

Please list any medical conditions or allergies that may affect your child's involvement in this program.

Comments

Please share anything you'd like us to know about your child and their participation in this program.

Youth Ministry | Edge Registration