Southern Maryland Youth Day Registration

First Name:
Last Name:
Date of Birth:
Grade:	Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 Chaperone
Parish:**	St. Aloysius St. John Francis Regis Immaculate Heart of Mary St. Peter Claver St. Michael Immaculate Conception Our Lady's at Medley's Neck Holy Angels Sacred Heart (Bushwood) Holy Face St. Joseph (Morganza) Our Lady of the Wayside St. Cecilia St. Francis Xavier St. George St. Nicholas Jesus the Divine Word Jesus the Good Shepherd St. Anthony St. John Vianney Our Lady Star of the Sea Holy Ghost Our Lady Help of Christians Sacred Heart (La Plata) St. Catherine of Alexandria St. Francis de Sales St. Ignatius, Chapel Point St. Ignatius Loyola, Hilltop St. Joseph (Pomfret) St. Mary (Bryantown) St. Mary Star of the Sea St. Mary (Newport) St. Peter
T-Shirt Size:	No Shirt, Please S M L XL XXL
Email:

** - If you do not belong to a Catholic parish and are attending with a friend who does, please select the parish of the friend who invited you. For security reasons, each teen must be accompanied by parish chaperones throughout the event. Please contact youthday2009@stmaryscatholicyouth.com if you have any questions.

PLEASE READ CAREFULLY

In order to register for Southern Maryland Youth Day 2009, you MUST print out and complete the release and consent form (RELEASE AND CONSENT FORM 2010.pdf). Please turn in your registration form to your parish Youth Minister, Director of Religious Education, or Pastor. If you are not affiliated with a parish but are attending with a friend, submit your form with payment to your friend's parish.  The cost of participation is $25, made payable to "IHM - Youth Day."

I understand that I must download, complete, and submit a release and consent form to my parish in order to complete my registration.