LYA Registration 2018-06-18T04:27:08+00:00

LYA Registration 2018

Use this form to register for Lasallian Youth Assembly 2018 gathering.

Your Information

First Name *

Last Name *

Gender (scroll to select) *

Email *

Phone *

Address *

City *

State (scroll to select) *

Zip *

School* (scroll and select one)

Class Of *

Emergency Contact Person *

Emergency Phone *

Please check all that apply:
SingerMusicianReaderEucharistic MinisterPrevious Attendee

If you are a student, what is your school leadership role?

Are you a moderator? (scroll to select) *

T-shirt size? (scroll to select) *

Allergies (including food) and /or special dietary needs. (scroll to select) * (If yes, please list below.)

Other concerns or needs. (If none, indicate "none".) *