Participant(s) Information

I am in . . . *

Jr. High

High School

First Name *

Last Name *

Sex *

Grade *

School *

Student's Email

Do you have any pet or food allergies? *

None	Cat
Dog	Other Other

Household / Adult Primary Contact

Mom's 1st Name *

Dad's 1st Name *

Address 1 *

City *

State *

Zip *

Home Phone (i.e. 913.888.7777) *

Emergency/Cell Phone

Receive Mass Email?

Please leave checked so we can email you info and updates

Parent's Email Address *

I will pay . . . *

I'm part of High School team	in Parish Office
I'm interested in financial scholarship

Sleep Home Partner Request
please list ONLY ONE name