Fiat Girl's Small Group Registration

Number of girls registering(Required)

Girl 1 Information

Girl 1 Name(Required)

First Last

Girl 1 Grade(Required)

Girl 1 School(Required)

Girl 2 Information

Girl 2 Name(Required)

First Last

Girl 2 Grade(Required)

Girl 2 School(Required)

Girl 3 Information

Girl 3 Name(Required)

First Last

Girl 3 Grade(Required)

Girl 3 School(Required)

Girl 4 Information

Girl 4 Name(Required)

First Last

Girl 4 Grade(Required)

Girl 4 School(Required)

Parent Information

Parent 1 Name(Required)

First Last

Parent 2 Name

First Last

Parent Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parent Phone(Required)

Parent Email(Required)

Family Parish(Required)

Alternate Emergency Contact

Emergency Contact Name(Required)

First Last

Emergency Contact Relationship(Required)

Emergency Contact Phone(Required)

Child(ren) Allergy and Medical Disclosure

Does your child(ren) have any allergies, current medications, special needs or other medical conditions you would like adult leaders and volunteers to be aware of?(Required)

Photograph Consent(Required)

By clicking “I agree” and participating in any of the Fiat program’s various activities, events, volunteer opportunities, etc., I authorize Holy Spirit to use my youth’s picture or video recording for social/advertising purposes to include but not limited to the parish website, parish social media, and bulletin boards on church grounds.

Fiat Girl’s Small Group Registration

Girl 1 Information

Girl 2 Information

Girl 3 Information

Girl 4 Information

Parent Information

Alternate Emergency Contact

Child(ren) Allergy and Medical Disclosure