Fully Alive! Health and Freedom Event

Personal Information:

Last Name*
Email*
Phone*
Your Parish/Community (Name and Location)
First names of all family members attending, including grade-level of any young people attending:

Do you have dietary restrictions? If so, please indicate:
Advisory:
Agree
Disagree

I, the parent or guardian of this/these registrant(s), understand that this program will include age-appropriate information and discussion on human relationships, including human sexuality from a Catholic perspective, and basic fertility awareness.

Payment Information:
Payment Payment amount: $

Pay with Credit Card

For more information, please feel free to contact Janene Loughran at 585-329-1974 or Janene_loughran@yahoo.com.