St. John Vianney Church
CYBL Registration
Volunteer Information
First Name:
First Name is a required field.
Last Name:
Last Name is a required field
Nick Name:
Address 1:
Address 1 is a required field
Address 2:
City:
City is a required field
State:
MD
VA
State is a required field
Zip Code:
Zip Code is a required field
Zip Code must be 5 numeric digits
Birthdate
mm/dd/yyyy
Not a valid Date
Birthdate is a required field
Sex
M
F
Required field
Home Phone:
(10 numeric digits)
Home Phone is a required field
Phone Number must be 10 numeric digits
Cell Phone:
Must be 10 numeric digits
SJV Parishoner
Yes
No
Required Field
E-mail Primary:
Not a valid E-mail address.
E-mail Required
Re-enter Email Primary:
Not a valid E-mail address
E-mail Required
Email Secondary
Not a valid E-mail address
Volunteer For:
Coach
Assistant Coach
Referee
Snack Bar
General Helper
Required Field
Shirt Size:
S
M
L
XL
XXL
Required Field
No
Yes
I have previously completed ADW Child Protection registration (Volunteer Application, Attended Class, and Background Check)
Requests:
Assumption of Risk
By executing this registration form the named participant represents and warrants that they are unaware of any physical or mental impediment that would or could cause injury or harm to the participant or to others by the said participant’s participation in the activities of the St. John Vianney Family Life Center. Due to the strenuous nature of some activities, the participant is urged to consult a physician concerning their fitness to engage in activities prior to executing this registration. Since all activities present certain inherent and/or inadvertent risks and hazards, know and acknowledge by the undersigned, by their execution hereof, assume all liability incident to the said participation, except that liability, which is imposed by law on the Catholic Archdiocese of Washington, their employees, agents or volunteers.
Electronic Signature (Full Name)
Required Field
Full Name Required - Letters Only
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