BASH 2022 Form

Number of Youth Participants*

Number of Adult Chaperones*

Youth #1

Youth #1*

First Last

Youth #1 Shirt Size*

First Last

Youth #2 Shirt Size*

First Last

Youth #3 Shirt Size*

Parent Name*

First Last

Parent Email*

Enter Email Confirm Email

Best phone number to contact parent during event*

Liability Form*

I have completed a Youth Registration/Liability Form on line this school year.
I HAVE NOT completed a Youth Registration/Liability Form on line this school year.

Driver/Chaperone?*

I would love to volunteer to drive to and chaperone at for BASH. I understand I would not be able to bring my other children.
Oh no, I am so sorry I cannot help on this Adventure. I will have to keep an eye out for the next adventure so I can be sure to have some fun with my youth!

Driver/Chaperone Name*

First Last

Driver/Chaperone Shirt Size*

How many seatbelts do you have in your car (including the driver's seatbelt)?*

Driver/Chaperone Email*

Enter Email Confirm Email

Driver/Chaperone Cell Phone*

Child Protection Compliance*

I am FULLY compliant with the Child Protection Policy of the Diocese of Arlington
I think I am. Will you check? If not, I'll make it happen!
I am not, but I would love to become fully compliant in time for this event. Please contact me!

Total MSYM BASH

$0.00

Credit Card

Card Details

Cardholder Name