Online Registration Form

Youth Information

Number of Youth Registering REQUIRED Please fill out this field.
Youth # 1
- Youth's Name REQUIRED Please fill out this field. Please enter valid data.
- Youth's Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Text Messaging OK? REQUIRED Yes No Please fill out this field.
- Age REQUIRED Please fill out this field. Please enter valid data.
- Grade in School REQUIRED Please fill out this field. Please enter valid data.
- Group in Youth Ministry REQUIRED Please fill out this field.
- What Sacraments has your student recieved?
- Baptized (Check one) REQUIRED Yes No Please fill out this field.
- First Reconciliation (Check one) REQUIRED Yes No Please fill out this field.
- First Communion (Check one) REQUIRED Yes No Please fill out this field.
- Confirmation (Check one) REQUIRED Yes No Please fill out this field.
- Which Sacraments would you like your son/daughter to receive this year? Baptism First Communion Confirmation
Youth # 2
- Youth's Name REQUIRED Please fill out this field. Please enter valid data.
- Youth's Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Text Messaging OK? REQUIRED Yes No Please fill out this field.
- Age REQUIRED Please fill out this field. Please enter valid data.
- Grade in School REQUIRED Please fill out this field. Please enter valid data.
- Group in Youth Ministry REQUIRED Please fill out this field.
- What Sacraments has your student recieved?
- Baptized (Check one) REQUIRED Yes No Please fill out this field.
- First Reconciliation (Check one) REQUIRED Yes No Please fill out this field.
- First Communion (Check one) REQUIRED Yes No Please fill out this field.
- Confirmation (Check one) REQUIRED Yes No Please fill out this field.
- Which Sacraments would you like your son/daughter to receive this year? Baptism First Communion Confirmation
Youth # 3
- Youth's Name REQUIRED Please fill out this field. Please enter valid data.
- Youth's Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Text Messaging OK? REQUIRED Yes No Please fill out this field.
- Age REQUIRED Please fill out this field. Please enter valid data.
- Grade in School REQUIRED Please fill out this field. Please enter valid data.
- Group in Youth Ministry REQUIRED Please fill out this field.
- What Sacraments has your student recieved?
- Baptized (Check one) REQUIRED Yes No Please fill out this field.
- First Reconciliation (Check one) REQUIRED Yes No Please fill out this field.
- First Communion (Check one) REQUIRED Yes No Please fill out this field.
- Confirmation (Check one) REQUIRED Yes No Please fill out this field.
- Which Sacraments would you like your son/daughter to receive this year? Baptism First Communion Confirmation
Youth # 4
- Youth's Name REQUIRED Please fill out this field. Please enter valid data.
- Youth's Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Text Messaging OK? REQUIRED Yes No Please fill out this field.
- Age REQUIRED Please fill out this field. Please enter valid data.
- Grade in School REQUIRED Please fill out this field. Please enter valid data.
- Group in Youth Ministry REQUIRED Please fill out this field.
- What Sacraments has your student recieved?
- Baptized (Check one) REQUIRED Yes No Please fill out this field.
- First Reconciliation (Check one) REQUIRED Yes No Please fill out this field.
- First Communion (Check one) REQUIRED Yes No Please fill out this field.
- Confirmation (Check one) REQUIRED Yes No Please fill out this field.
- Which Sacraments would you like your son/daughter to receive this year? Baptism First Communion Confirmation
Youth # 5
- Youth's Name REQUIRED Please fill out this field. Please enter valid data.
- Youth's Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Text Messaging OK? REQUIRED Yes No Please fill out this field.
- Age REQUIRED Please fill out this field. Please enter valid data.
- Grade in School REQUIRED Please fill out this field. Please enter valid data.
- Group in Youth Ministry REQUIRED Please fill out this field.
- What Sacraments has your student recieved?
- Baptized (Check one) REQUIRED Yes No Please fill out this field.
- First Reconciliation (Check one) REQUIRED Yes No Please fill out this field.
- First Communion (Check one) REQUIRED Yes No Please fill out this field.
- Confirmation (Check one) REQUIRED Yes No Please fill out this field.
- Which Sacraments would you like your son/daughter to receive this year? Baptism First Communion Confirmation
Youth # 6
- Youth's Name REQUIRED Please fill out this field. Please enter valid data.
- Youth's Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Text Messaging OK? REQUIRED Yes No Please fill out this field.
- Age REQUIRED Please fill out this field. Please enter valid data.
- Grade in School REQUIRED Please fill out this field. Please enter valid data.
- Group in Youth Ministry REQUIRED Please fill out this field.
- What Sacraments has your student recieved?
- Baptized (Check one) REQUIRED Yes No Please fill out this field.
- First Reconciliation (Check one) REQUIRED Yes No Please fill out this field.
- First Communion (Check one) REQUIRED Yes No Please fill out this field.
- Confirmation (Check one) REQUIRED Yes No Please fill out this field.
- Which Sacraments would you like your son/daughter to receive this year? Baptism First Communion Confirmation
Youth # 7
- Youth's Name REQUIRED Please fill out this field. Please enter valid data.
- Youth's Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Text Messaging OK? REQUIRED Yes No Please fill out this field.
- Age REQUIRED Please fill out this field. Please enter valid data.
- Grade in School REQUIRED Please fill out this field. Please enter valid data.
- Group in Youth Ministry REQUIRED Please fill out this field.
- What Sacraments has your student recieved?
- Baptized (Check one) REQUIRED Yes No Please fill out this field.
- First Reconciliation (Check one) REQUIRED Yes No Please fill out this field.
- First Communion (Check one) REQUIRED Yes No Please fill out this field.
- Confirmation (Check one) REQUIRED Yes No Please fill out this field.
- Which Sacraments would you like your son/daughter to receive this year? Baptism First Communion Confirmation
Youth # 8
- Youth's Name REQUIRED Please fill out this field. Please enter valid data.
- Youth's Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Text Messaging OK? REQUIRED Yes No Please fill out this field.
- Age REQUIRED Please fill out this field. Please enter valid data.
- Grade in School REQUIRED Please fill out this field. Please enter valid data.
- Group in Youth Ministry REQUIRED Please fill out this field.
- What Sacraments has your student recieved?
- Baptized (Check one) REQUIRED Yes No Please fill out this field.
- First Reconciliation (Check one) REQUIRED Yes No Please fill out this field.
- First Communion (Check one) REQUIRED Yes No Please fill out this field.
- Confirmation (Check one) REQUIRED Yes No Please fill out this field.
- Which Sacraments would you like your son/daughter to receive this year? Baptism First Communion Confirmation
Youth # 9
- Youth's Name REQUIRED Please fill out this field. Please enter valid data.
- Youth's Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Text Messaging OK? REQUIRED Yes No Please fill out this field.
- Age REQUIRED Please fill out this field. Please enter valid data.
- Grade in School REQUIRED Please fill out this field. Please enter valid data.
- Group in Youth Ministry REQUIRED Please fill out this field.
- What Sacraments has your student recieved?
- Baptized (Check one) REQUIRED Yes No Please fill out this field.
- First Reconciliation (Check one) REQUIRED Yes No Please fill out this field.
- First Communion (Check one) REQUIRED Yes No Please fill out this field.
- Confirmation (Check one) REQUIRED Yes No Please fill out this field.
- Which Sacraments would you like your son/daughter to receive this year? Baptism First Communion Confirmation
Youth # 10
- Youth's Name REQUIRED Please fill out this field. Please enter valid data.
- Youth's Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Text Messaging OK? REQUIRED Yes No Please fill out this field.
- Age REQUIRED Please fill out this field. Please enter valid data.
- Grade in School REQUIRED Please fill out this field. Please enter valid data.
- Group in Youth Ministry REQUIRED Please fill out this field.
- What Sacraments has your student recieved?
- Baptized (Check one) REQUIRED Yes No Please fill out this field.
- First Reconciliation (Check one) REQUIRED Yes No Please fill out this field.
- First Communion (Check one) REQUIRED Yes No Please fill out this field.
- Confirmation (Check one) REQUIRED Yes No Please fill out this field.
- Which Sacraments would you like your son/daughter to receive this year? Baptism First Communion Confirmation

Parent or Guardian Information

Is your family registered as parishioners at St. Henry's? REQUIRED Yes No Please fill out this field.

Mother's First Name Please enter valid data.

Mother's Last Name Please enter valid data.

Mother's Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Mother's Email REQUIRED Please fill out this field. Please enter an email address.

Father's First Name Please enter valid data.

Father's Last Name Please enter valid data.

Father's Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Father's Email REQUIRED Please fill out this field. Please enter an email address.

Family's Street Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Home Phone Number Please enter a phone number.

Email Address REQUIRED Please fill out this field. Please enter valid data.

Work Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Emergency Information: In the event of emergency, when you cannot be reached, whom should we contact?

Contact Name REQUIRED Please fill out this field. Please enter valid data.

Contact Phone Number REQUIRED Please fill out this field. Please enter a phone number.

**If the legal guardian or emergency contact cannot be reached, the bearer of this form is authorized to act on my behalf to seek medical treatment as they deem necessary for the child (ren) listed on this registration. I also understand and agree that the Archdiocese of Portland and St. Henry Catholic Church assumes no financial obligation for expenses incurred in carrying out emergency procedures and/or transportation. In addition, I give permission for my child (children) to be escorted from the parish center to the church on those occasions when their class visits the church.

**I give permission for my child/(ren)’s pictures to be used in displays, brochures and on the web-site to communicate the importance of parish life to our members. *NO NAMES will be published.

Parent Signature REQUIRED Please fill out this field. Please enter valid data.

Email REQUIRED Please fill out this field. Please enter an email address.

There is a $80 fee per child for registration. If you have two children in the program, then the fee is $100. For three or more children, the fee is $120. Please make a check out to St. Henry's or pay cash to the office.

There will also be a fee associated with the Confirmation 2 Retreat, amount TBD.

St. Henry Catholic Church

Gresham, Oregon

Online Registration Form

2021-2022 Youth Ministry Online Registration

Youth Information

Parent or Guardian Information