First Adult Leader Name*
First
Last
Home Phone*
Cell Phone*
Email*
Age* as of June 29, 2020
Gender* Has this person been screened under the Archdiocese of Vancouver's Safe Environment Policy?* What parish or school has this person been screened at?
Does this adult leader have any experience or training in ministry?
Health Information BC Services Card Number*
Family Physician*
Physician Phone Number*
Specific medical allergies, chronic illnesses or other condition, behavioural needs, dietary needs and any current medications Please be as concise as possible
Person(s) to contact in case of emergency Name*
Relation*
Phone*
Name
Relation
Phone
Second Adult Leader Name*
First
Last
Home Phone*
Cell Phone*
Email*
Age* as of June 29, 2020
Gender* Has this person been screened under the Archdiocese of Vancouver's Safe Environment Policy?* What parish or school has this person been screened at?*
Does this adult leader have any experience or training in ministry?
Health Information BC Services Card Number*
Family Physician*
Physician Phone Number*
Specific medical allergies, chronic illnesses or other condition, behavioural needs, dietary needs and any current medications Please be as concise as possible
Person(s) to contact in case of emergency Name*
Relation*
Phone*
Name
Relation
Phone
Third Adult Leader Name*
First
Last
Home Phone*
Cell Phone*
Email*
Age* as of June 29, 2020
Gender* Has this person been screened under the Archdiocese of Vancouver's Safe Environment Policy?* What parish or school has this person been screened at?*
Does this person have experience or training in ministry?
Health Information BC Services Card Number*
Family Physician*
Physician Phone Number*
Specific medical allergies, chronic illnesses or other condition, behavioural needs, dietary needs and any current medications Please be as concise as possible
Person(s) to contact in case of emergency Name*
Relation*
Phone*
Name
Relation
Phone
1st Youth Participant Name*
First
Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Gender* T-shirt size* (These are adult sizes)
School in September 2020-2021* -- Select One -- Archbishop Carney Secondary (Port Coquitlam) Holy Cross Secondary (Surrey) Little Flower Academy Secondary (Vancouver) Notre Dame Secondary (Vancouver) Seminary of Christ the King Secondary (Mission) St. John Brebeuf Secondary (Abbotsford) St. John Paul II Academy St. Patrick's Secondary (Vancouver) St. Thomas Aquinas Secondary (North Vancouver) St. Thomas More Collegiate Secondary (Burnaby) Vancouver College Secondary (Vancouver) Other
School Name*
Grade*
Confirmation Year* BC Services Card Number*
Family Physician*
Physician Phone Number*
Specific medical allergies, chronic illnesses or other condition, behavioural needs, dietary needs and any current medications Please be as concise as possible
Person(s) to contact in case of emergency Name*
Relation*
Phone*
Name
Relation
Phone
2nd Youth Participant Name*
First
Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Gender* T-shirt size* (These are adult sizes)
School in September 2020-2021* -- Select One -- Archbishop Carney Secondary (Port Coquitlam) Holy Cross Secondary (Surrey) Little Flower Academy Secondary (Vancouver) Notre Dame Secondary (Vancouver) Seminary of Christ the King Secondary (Mission) St. John Brebeuf Secondary (Abbotsford) St. John Paul II Academy St. Patrick's Secondary (Vancouver) St. Thomas Aquinas Secondary (North Vancouver) St. Thomas More Collegiate Secondary (Burnaby) Vancouver College Secondary (Vancouver) Other
School Name*
Grade*
Confirmation Year* BC Services Card Number*
Family Physician*
Physician Phone Number*
Specific medical allergies, chronic illnesses or other condition, behavioural needs, dietary needs and any current medications Please be as concise as possible
Person(s) to contact in case of emergency Name*
Relation*
Phone*
Name
Relation
Phone
3rd Youth Participant Name*
First
Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Gender* T-shirt size* (These are adult sizes)
School in September 2020-2021* -- Select One -- Archbishop Carney Secondary (Port Coquitlam) Holy Cross Secondary (Surrey) Little Flower Academy Secondary (Vancouver) Notre Dame Secondary (Vancouver) Seminary of Christ the King Secondary (Mission) St. John Brebeuf Secondary (Abbotsford) St. John Paul II Academy St. Patrick's Secondary (Vancouver) St. Thomas Aquinas Secondary (North Vancouver) St. Thomas More Collegiate Secondary (Burnaby) Vancouver College Secondary (Vancouver) Other
School Name*
Grade*
Confirmation Year* BC Services Card Number*
Family Physician*
Physician Phone Number*
Specific medical allergies, chronic illnesses or other condition, behavioural needs, dietary needs and any current medications Please be as concise as possible
Person(s) to contact in case of emergency Name*
Relation*
Phone*
Name
Relation
Phone
4th Youth Participant Name*
First
Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Gender* T-shirt size* (These are adult sizes)
School in September 2020-2021* -- Select One -- Archbishop Carney Secondary (Port Coquitlam) Holy Cross Secondary (Surrey) Little Flower Academy Secondary (Vancouver) Notre Dame Secondary (Vancouver) Seminary of Christ the King Secondary (Mission) St. John Brebeuf Secondary (Abbotsford) St. John Paul II Academy St. Patrick's Secondary (Vancouver) St. Thomas Aquinas Secondary (North Vancouver) St. Thomas More Collegiate Secondary (Burnaby) Vancouver College Secondary (Vancouver) Other
School Name*
Grade*
Confirmation Year* BC Services Card Number*
Family Physician*
Physician Phone Number*
Specific medical allergies, chronic illnesses or other condition, behavioural needs, dietary needs and any current medications Please be as concise as possible
Person(s) to contact in case of emergency Name*
Relation*
Phone*
Name
Relation
Phone
5th Youth Participant Name*
First
Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Gender* T-shirt size* (These are adult sizes)
School in September 2020-2021* -- Select One -- Archbishop Carney Secondary (Port Coquitlam) Holy Cross Secondary (Surrey) Little Flower Academy Secondary (Vancouver) Notre Dame Secondary (Vancouver) Seminary of Christ the King Secondary (Mission) St. John Brebeuf Secondary (Abbotsford) St. John Paul II Academy St. Patrick's Secondary (Vancouver) St. Thomas Aquinas Secondary (North Vancouver) St. Thomas More Collegiate Secondary (Burnaby) Vancouver College Secondary (Vancouver) Other
School Name*
Grade*
Confirmation Year* BC Services Card Number*
Family Physician*
Physician Phone Number*
Specific medical allergies, chronic illnesses or other condition, behavioural needs, dietary needs and any current medications Please be as concise as possible
Person(s) to contact in case of emergency Name*
Relation*
Phone*
Name
Relation
Phone
6th Youth Participant Name*
First
Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Gender* T-shirt size* (These are adult sizes)
School in September 2020-2021* -- Select One -- Archbishop Carney Secondary (Port Coquitlam) Holy Cross Secondary (Surrey) Little Flower Academy Secondary (Vancouver) Notre Dame Secondary (Vancouver) Seminary of Christ the King Secondary (Mission) St. John Brebeuf Secondary (Abbotsford) St. John Paul II Academy St. Patrick's Secondary (Vancouver) St. Thomas Aquinas Secondary (North Vancouver) St. Thomas More Collegiate Secondary (Burnaby) Vancouver College Secondary (Vancouver) Other
School Name*
Grade*
Confirmation Year* BC Services Card Number*
Family Physician*
Physician Phone Number*
Specific medical allergies, chronic illnesses or other condition, behavioural needs, dietary needs and any current medications Please be as concise as possible
Person(s) to contact in case of emergency Name*
Relation*
Phone*
Name
Relation
Phone
7th Youth Participant Name*
First
Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Gender* T-shirt size* (These are adult sizes)
School in September 2020-2021* -- Select One -- Archbishop Carney Secondary (Port Coquitlam) Holy Cross Secondary (Surrey) Little Flower Academy Secondary (Vancouver) Notre Dame Secondary (Vancouver) Seminary of Christ the King Secondary (Mission) St. John Brebeuf Secondary (Abbotsford) St. John Paul II Academy St. Patrick's Secondary (Vancouver) St. Thomas Aquinas Secondary (North Vancouver) St. Thomas More Collegiate Secondary (Burnaby) Vancouver College Secondary (Vancouver) Other
School Name*
Grade*
Confirmation Year* BC Services Card Number*
Family Physician*
Physician Phone Number*
Specific medical allergies, chronic illnesses or other condition, behavioural needs, dietary needs and any current medications Please be as concise as possible
Person(s) to contact in case of emergency Name*
Relation*
Phone*
Name
Relation
Phone
8th Youth Participant Name*
First
Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Gender* T-shirt size* (These are adult sizes)
School in September 2020-2021* -- Select One -- Archbishop Carney Secondary (Port Coquitlam) Holy Cross Secondary (Surrey) Little Flower Academy Secondary (Vancouver) Notre Dame Secondary (Vancouver) Seminary of Christ the King Secondary (Mission) St. John Brebeuf Secondary (Abbotsford) St. John Paul II Academy St. Patrick's Secondary (Vancouver) St. Thomas Aquinas Secondary (North Vancouver) St. Thomas More Collegiate Secondary (Burnaby) Vancouver College Secondary (Vancouver) Other
School Name*
Grade*
Confirmation Year* BC Services Card Number*
Family Physician*
Physician Phone Number*
Specific medical allergies, chronic illnesses or other condition, behavioural needs, dietary needs and any current medications Please be as concise as possible
Person(s) to contact in case of emergency Name*
Relation*
Phone*
Name
Relation
Phone
9th Youth Participant Name*
First
Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Gender* T-shirt size* (These are adult sizes)
School in September 2020-2021* -- Select One -- Archbishop Carney Secondary (Port Coquitlam) Holy Cross Secondary (Surrey) Little Flower Academy Secondary (Vancouver) Notre Dame Secondary (Vancouver) Seminary of Christ the King Secondary (Mission) St. John Brebeuf Secondary (Abbotsford) St. John Paul II Academy St. Patrick's Secondary (Vancouver) St. Thomas Aquinas Secondary (North Vancouver) St. Thomas More Collegiate Secondary (Burnaby) Vancouver College Secondary (Vancouver) Other
School Name*
Grade*
Confirmation Year* BC Services Card Number*
Family Physician*
Physician Phone Number*
Specific medical allergies, chronic illnesses or other condition, behavioural needs, dietary needs and any current medications Please be as concise as possible
Person(s) to contact in case of emergency Name*
Relation*
Phone*
Name
Relation
Phone
10th Youth Participant Name*
First
Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Gender* T-shirt size* (These are adult sizes)
School in September 2020-2021* -- Select One -- Archbishop Carney Secondary (Port Coquitlam) Holy Cross Secondary (Surrey) Little Flower Academy Secondary (Vancouver) Notre Dame Secondary (Vancouver) Seminary of Christ the King Secondary (Mission) St. John Brebeuf Secondary (Abbotsford) St. John Paul II Academy St. Patrick's Secondary (Vancouver) St. Thomas Aquinas Secondary (North Vancouver) St. Thomas More Collegiate Secondary (Burnaby) Vancouver College Secondary (Vancouver) Other
School Name*
Grade*
Confirmation Year* BC Services Card Number*
Family Physician*
Physician Phone Number*
Specific medical allergies, chronic illnesses or other condition, behavioural needs, dietary needs and any current medications Please be as concise as possible
Person(s) to contact in case of emergency Name*
Relation*
Phone*
Name
Relation
Phone
11th Youth Participant Name*
First
Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Gender* T-shirt size* (These are adult sizes)
School in September 2020-2021* -- Select One -- Archbishop Carney Secondary (Port Coquitlam) Holy Cross Secondary (Surrey) Little Flower Academy Secondary (Vancouver) Notre Dame Secondary (Vancouver) Seminary of Christ the King Secondary (Mission) St. John Brebeuf Secondary (Abbotsford) St. John Paul II Academy St. Patrick's Secondary (Vancouver) St. Thomas Aquinas Secondary (North Vancouver) St. Thomas More Collegiate Secondary (Burnaby) Vancouver College Secondary (Vancouver) Other
School Name*
Grade*
Confirmation Year* BC Services Card Number*
Family Physician*
Physician Phone Number*
Specific medical allergies, chronic illnesses or other condition, behavioural needs, dietary needs and any current medications Please be as concise as possible
Person(s) to contact in case of emergency Name*
Relation*
Phone*
Name
Relation
Phone
12th Youth Participant Name*
First
Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Gender* T-shirt size* (These are adult sizes)
School in September 2020-2021* -- Select One -- Archbishop Carney Secondary (Port Coquitlam) Holy Cross Secondary (Surrey) Little Flower Academy Secondary (Vancouver) Notre Dame Secondary (Vancouver) Seminary of Christ the King Secondary (Mission) St. John Brebeuf Secondary (Abbotsford) St. John Paul II Academy St. Patrick's Secondary (Vancouver) St. Thomas Aquinas Secondary (North Vancouver) St. Thomas More Collegiate Secondary (Burnaby) Vancouver College Secondary (Vancouver) Other
School Name*
Grade*
Confirmation Year* BC Services Card Number*
Family Physician*
Physician Phone Number*
Specific medical allergies, chronic illnesses or other condition, behavioural needs, dietary needs and any current medications Please be as concise as possible
Person(s) to contact in case of emergency Name*
Relation*
Phone*
Name
Relation
Phone
13th Youth Participant Name*
First
Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Gender* T-shirt size* (These are adult sizes)
School in September 2020-2021* -- Select One -- Archbishop Carney Secondary (Port Coquitlam) Holy Cross Secondary (Surrey) Little Flower Academy Secondary (Vancouver) Notre Dame Secondary (Vancouver) Seminary of Christ the King Secondary (Mission) St. John Brebeuf Secondary (Abbotsford) St. John Paul II Academy St. Patrick's Secondary (Vancouver) St. Thomas Aquinas Secondary (North Vancouver) St. Thomas More Collegiate Secondary (Burnaby) Vancouver College Secondary (Vancouver) Other
School Name*
Grade*
Confirmation Year* BC Services Card Number*
Family Physician*
Physician Phone Number*
Specific medical allergies, chronic illnesses or other condition, behavioural needs, dietary needs and any current medications Please be as concise as possible
Person(s) to contact in case of emergency Name*
Relation*
Phone*
Name
Relation
Phone
14th Youth Participant Name*
First
Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Gender* T-shirt size* (These are adult sizes)
School in September 2020-2021* -- Select One -- Archbishop Carney Secondary (Port Coquitlam) Holy Cross Secondary (Surrey) Little Flower Academy Secondary (Vancouver) Notre Dame Secondary (Vancouver) Seminary of Christ the King Secondary (Mission) St. John Brebeuf Secondary (Abbotsford) St. John Paul II Academy St. Patrick's Secondary (Vancouver) St. Thomas Aquinas Secondary (North Vancouver) St. Thomas More Collegiate Secondary (Burnaby) Vancouver College Secondary (Vancouver) Other
School Name*
Grade*
Confirmation Year* BC Services Card Number*
Family Physician*
Physician Phone Number*
Specific medical allergies, chronic illnesses or other condition, behavioural needs, dietary needs and any current medications Please be as concise as possible
Person(s) to contact in case of emergency Name*
Relation*
Phone*
Name
Relation
Phone
15th Youth Participant Name*
First
Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Gender* T-shirt size* (These are adult sizes)
School in September 2020-2021* -- Select One -- Archbishop Carney Secondary (Port Coquitlam) Holy Cross Secondary (Surrey) Little Flower Academy Secondary (Vancouver) Notre Dame Secondary (Vancouver) Seminary of Christ the King Secondary (Mission) St. John Brebeuf Secondary (Abbotsford) St. John Paul II Academy St. Patrick's Secondary (Vancouver) St. Thomas Aquinas Secondary (North Vancouver) St. Thomas More Collegiate Secondary (Burnaby) Vancouver College Secondary (Vancouver) Other
School Name*
Grade*
Confirmation Year* BC Services Card Number*
Family Physician*
Physician Phone Number*
Specific medical allergies, chronic illnesses or other condition, behavioural needs, dietary needs and any current medications Please be as concise as possible
Person(s) to contact in case of emergency Name*
Relation*
Phone*
Name
Relation
Phone
16th Youth Participant Name*
First
Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Gender* T-shirt size* (These are adult sizes)
School in September 2020-2021* -- Select One -- Archbishop Carney Secondary (Port Coquitlam) Holy Cross Secondary (Surrey) Little Flower Academy Secondary (Vancouver) Notre Dame Secondary (Vancouver) Seminary of Christ the King Secondary (Mission) St. John Brebeuf Secondary (Abbotsford) St. John Paul II Academy St. Patrick's Secondary (Vancouver) St. Thomas Aquinas Secondary (North Vancouver) St. Thomas More Collegiate Secondary (Burnaby) Vancouver College Secondary (Vancouver) Other
School Name*
Grade*
Confirmation Year* BC Services Card Number*
Family Physician*
Physician Phone Number*
Specific medical allergies, chronic illnesses or other condition, behavioural needs, dietary needs and any current medications Please be as concise as possible
Person(s) to contact in case of emergency Name*
Relation*
Phone*
Name
Relation
Phone
17th Youth Participant Name*
First
Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Gender* T-shirt size* (These are adult sizes)
School in September 2020-2021* -- Select One -- Archbishop Carney Secondary (Port Coquitlam) Holy Cross Secondary (Surrey) Little Flower Academy Secondary (Vancouver) Notre Dame Secondary (Vancouver) Seminary of Christ the King Secondary (Mission) St. John Brebeuf Secondary (Abbotsford) St. John Paul II Academy St. Patrick's Secondary (Vancouver) St. Thomas Aquinas Secondary (North Vancouver) St. Thomas More Collegiate Secondary (Burnaby) Vancouver College Secondary (Vancouver) Other
School Name*
Grade*
Confirmation Year* BC Services Card Number*
Family Physician*
Physician Phone Number*
Specific medical allergies, chronic illnesses or other condition, behavioural needs, dietary needs and any current medications Please be as concise as possible
Person(s) to contact in case of emergency Name*
Relation*
Phone*
Name
Relation
Phone
18th Youth Participant Name*
First
Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Gender* T-shirt size* (These are adult sizes)
School in September 2020-2021* -- Select One -- Archbishop Carney Secondary (Port Coquitlam) Holy Cross Secondary (Surrey) Little Flower Academy Secondary (Vancouver) Notre Dame Secondary (Vancouver) Seminary of Christ the King Secondary (Mission) St. John Brebeuf Secondary (Abbotsford) St. John Paul II Academy St. Patrick's Secondary (Vancouver) St. Thomas Aquinas Secondary (North Vancouver) St. Thomas More Collegiate Secondary (Burnaby) Vancouver College Secondary (Vancouver) Other
School Name*
Grade*
Confirmation Year* BC Services Card Number*
Family Physician*
Physician Phone Number*
Specific medical allergies, chronic illnesses or other condition, behavioural needs, dietary needs and any current medications Please be as concise as possible
Person(s) to contact in case of emergency Name*
Relation*
Phone*
Name
Relation
Phone
19th Youth Participant Name*
First
Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Gender* T-shirt size* (These are adult sizes)
School in September 2020-2021* -- Select One -- Archbishop Carney Secondary (Port Coquitlam) Holy Cross Secondary (Surrey) Little Flower Academy Secondary (Vancouver) Notre Dame Secondary (Vancouver) Seminary of Christ the King Secondary (Mission) St. John Brebeuf Secondary (Abbotsford) St. John Paul II Academy St. Patrick's Secondary (Vancouver) St. Thomas Aquinas Secondary (North Vancouver) St. Thomas More Collegiate Secondary (Burnaby) Vancouver College Secondary (Vancouver) Other
School Name*
Grade*
Confirmation Year* BC Services Card Number*
Family Physician*
Physician Phone Number*
Specific medical allergies, chronic illnesses or other condition, behavioural needs, dietary needs and any current medications Please be as concise as possible
Person(s) to contact in case of emergency Name*
Relation*
Phone*
Name
Relation
Phone
20th Youth Participant Name*
First
Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Gender* T-shirt size* (These are adult sizes)
School in September 2020-2021* -- Select One -- Archbishop Carney Secondary (Port Coquitlam) Holy Cross Secondary (Surrey) Little Flower Academy Secondary (Vancouver) Notre Dame Secondary (Vancouver) Seminary of Christ the King Secondary (Mission) St. John Brebeuf Secondary (Abbotsford) St. John Paul II Academy St. Patrick's Secondary (Vancouver) St. Thomas Aquinas Secondary (North Vancouver) St. Thomas More Collegiate Secondary (Burnaby) Vancouver College Secondary (Vancouver) Other
School Name*
Grade*
Confirmation Year* BC Services Card Number*
Family Physician*
Physician Phone Number*
Specific medical allergies, chronic illnesses or other condition, behavioural needs, dietary needs and any current medications Please be as concise as possible
Person(s) to contact in case of emergency Name*
Relation*
Phone*
Name
Relation
Phone
Additional Leaders Would you like to add more adult leaders?* Additional Adult Leader Name*
First
Last
Home Phone*
Cell Phone*
Email*
Age*
Gender* Has this person been screened under the Archdiocese of Vancouver's Safe Environment Policy?* What parish or school has this person been screened at?*
Does this adult leader have any experience or training in ministry?
Health Information BC Services Card Number*
Family Physician*
Physician Phone Number*
Specific medical allergies, chronic illnesses or other condition, behavioural needs, dietary needs and any current medications Please be as concise as possible
Person(s) to contact in case of emergency Name*
Relation*
Phone*
Name
Relation
Phone
Additional Adult Leader Name*
First
Last
Home Phone*
Cell Phone*
Email*
Age*
Gender* Has this person been screened under the Archdiocese of Vancouver's Safe Environment Policy?* What parish or school has this person been screened at?*
Does this adult leader have any experience or training in ministry?
Health Information BC Services Card Number*
Family Physician*
Physician Phone Number*
Specific medical allergies, chronic illnesses or other condition, behavioural needs, dietary needs and any current medications Please be as concise as possible
Person(s) to contact in case of emergency Name*
Relation*
Phone*
Name
Relation
Phone
Additional Adult Leader Name*
First
Last
Home Phone*
Cell Phone*
Email*
Age*
Gender* Has this person been screened under the Archdiocese of Vancouver's Safe Environment Policy?* What parish or school has this person been screened at?*
Does this adult leader have any experience or training in ministry?
Health Information BC Services Card Number*
Family Physician*
Physician Phone Number*
Specific medical allergies, chronic illnesses or other condition, behavioural needs, dietary needs and any current medications Please be as concise as possible
Person(s) to contact in case of emergency Name*
Relation*
Phone*
Name
Relation
Phone
