First Name

Last Name

Email Address

Phone Number (formatted with dashes: 123-456-7890)

Street/PO Address

City

State

Zip (5 digits)

Teen's email address

Birthdate (MM/DD/YYYY)

School Attending

Grade

Mother's Name

Mother's Cell Phone (formatted with dashes: 123-456-7890)

Father's Name

Father's Cell Phone (formatted with dashes: 123-456-7890)

Parent's Are:

Member Lives With

In Case of Emergency, Please Notify (Name)

Emergency Contact Phone (formatted with dashes: 123-456-7890)
]

VIRTUS Safe Environment Training

As mandated by the Archdiocese of Atlanta, STM will present the VIRTUS sexual abuse prevention program to our students every year. As a parent, you have the right to choose whether your student participates in the program. We encourage you to learn more here.

VIRTUS Safe Environment Training

Do you give permission for your child to participate in our yearly safe environment training that occurs every October?

Medical Emergency Waiver

In the event of an emergency, I give permission to transport my child to a hospital for medical attention. I wish to be advised prior to any further treatment. If you are unable to reach me, use the emergency contact listed above.
 Yes No

Media Waiver

I authorize my child to be included in publications, websites, or instructional activities, for STM or the Archdiocese of Atlanta, through photographs, videos, artwork, written work, or statements, in this or subsequent years.  Yes No

T-shirt Size (Adult sizes)

After registering, please submit your payment via STM Online Giving. Click Online Giving at the top of the page, log in, choose Give a New Gift and then choose Lifeteen Registration to complete the process. A 'quick give' is NOT accepted for payment of registration fees.

Please make sure to fill out the medical release & the annual permission slip. Your registration won't be able to be completed until ALL these forms are turned in.

  I understand my child won't be fully registered until I submit the payment, medical release form and permission slip.