Registration

After finishing this online registration form, please print and fill out the Child Comprehensive Medical Release & Permission Form.

Please send $10.00 registration fee and the Consent and Medical Forms to:

Diocese of La Crosse

Office of Vocations - Dare to Follow Days

P.O. Box 4004

La Crosse, WI 54602-4004

Please make checks payable to the Diocese of La Crosse

2011 Dare to Follow Registration Form
Participant's Name:*
Birth Date:*
Sex:*	MaleFemale
Parent/Guardian's Name:*
Street Address: *
City: *
State:*
Zip Code:*
Telephone: (home)*
Telephone: (work)
E-Mail:*
Parish:*
City:*
Which year of school are you entering in 2010-2011? *
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