Registration Form

(one per family)

Unfortunately, There are no more spaces available.

Please fill out the form below:

Parent/Guardian Name:

Child's Name:

Child's Age:

Address:

Home Telephone Number:

Mobile Telephone Number:

Home E-mail Address:

Number of family members participating in Rome:

Will parents be helping out in Rome?:

Where:

In case of emergency, contact:

Relationship to child:

Contact Number:

Allergies or other medical conditions:

Home Church:

Roman family name (for church use only):

Name of a special friend your child might like to be with: