Catholic Diocese of Wichita
Office of Youth & Young Adult Ministries

Youth Leadership Day Registration

CATHOLIC YOUTH LEADERSHIP DAY - 2008

"Upside-down Leadership"

Please select the session your group will attend.
If your group cannot attend the session scheduled for your Region you may attend another session.

September 7, Fredonia - Region 1

Cost is $15 per person.

All sessions are 1-6 p.m.

Parish Name

Parish City

Adult Contact Name

Adult Contact Phone #

Adult Contact E-mail

Youth Participants:

Youth First Name
Youth Last Name

Male

Female

Age

Grade

Address

City & Zip

Phone #

E-mail

Youth First Name
Youth Last Name

Male

Female

Age

Grade

Address

City & Zip

Phone #

E-mail

Youth First Name
Youth Last Name

Male

Female

Age

Grade

Address

City & Zip

Phone #

E-mail

Youth First Name
Youth Last Name

Male

Female

Age

Grade

Address

City & Zip

Phone #

E-mail

Youth First Name
Youth Last Name

Male

Female

Age

Grade

Address

City & Zip

Phone #

E-mail

Youth First Name
Youth Last Name

Male

Female

Age

Grade

Address

City & Zip

Phone #

E-mail

Adult Participants:

Adult First Name
Adult Last Name

Male

Female

Address

City & Zip

Phone #

E-mail

Adult First Name
Adult Last Name

Male

Female

Address

City & Zip

Phone #

E-mail

To finish:
1. Print a copy for yourself
2. Electronically submit the form to the Youth Office