Western Eparchy Youth
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Western Eparchy 2019 Youth Summit - Registration form
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Indicates required field
Name:
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Address
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Email
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Phone Number
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Age
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Children ages 8-10 must bring a parental chaperone. Chaperone is responsible for his/her own expenses.
Emergency Contact 1 (Name and Phone)
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Emergency Contact 2 (Name and Phone)
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Allergies/Dietary requirements (Please be detailed)
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Parish priest
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Parish
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Waiver Info
Please sign the waiver (link below) and upload it to this form or email it to Fr. Tim.
Waiver Upload
*
Max file size: 20MB
Submit
Waiver
Itinerary
Home
About Us
Orthodox Youth in Canada
Resources
Events
Camp Information
Past Events