Membership Registration and Renewal Form

If you are an existing member, or wanting to join the St. Rose Young Adult Group, please fill in the form below and select if you a Renewing, Registering, or just seeking for information. The completed form will then be emailed to you and you can than send the completed form in with your dues.

The St. Rose of Lima Young Adults' Group is dedicated to serving the spiritual, as well as the social needs of Catholics in their 20's and 30's, regardless of their marital status (single, married, etc.). Dues for 2008 are $17, which entitles the member to our monthly newsletter, as well as discounts at various group events. Other membership options include an internet-only membership for $8/yr., and a married couples rate of $20/yr. Please make checks payable to "St. Rose of Lima Young Adults' Group." For more information on the group, please contact Kathy Miller at joan0330@hotmail..com or 440-777-9115.

St. Rose of Lima Young Adults Group
Membership Application and Renewal Form

Name:
Address:
City: State: Zip:
Phone: (H) (C)
Email Address
Birthdate Age:
Home Parish
Marital Status
How did you hear about us?

Please rate the following on a scale of 1-4 (1 = Not Interested, 4 = Very Interested)

Spiritual

Bible Study / Catechism Study/ Books Club:
1 2 3 4
Group Holy Hour:
1 2 3 4
Men's/Women's Group:
1 2 3 4
Pilgrimages/Conferences (Steubenville, etc.):
1 2 3 4
Other:

Social

Concerts:
1 2 3 4
Sporting Events:
1 2 3 4
Restaurants:
1 2 3 4
Movies:
1 2 3 4
Athletic Activities(Volleyball, Softball, etc...):
1 2 3 4
Dancing:
1 2 3 4
Drama (Plays, musicals, etc...)
1 2 3 4
Other:

Service

Visiting Shut-ins:
1 2 3 4
Pro-Life work:
1 2 3 4
Assist with group/parish fundraising:
1 2 3 4
Habitat for Humanity:
1 2 3 4
Other:

I would be interested in possibly assisting the group in one of the following areas (Check all that apply):

Newsletter Committee
Spiritual Committee
Advertising/Marketing
Social Committee
Athletic Committee
Service Committee
Other:

Please Select your Membership Option:

I Just want more info!
Standard Membership ($17)
Internet Only Membership ($8)
Married Couples Membership ($20)

By Clicking "Submit" below, you agree to the following:

The undersigned, in condition of a member or a guest to St. Rose of Lima Young Adults' Group, hereby, absolutely, unconditionally and irrevocably waives any and all liability or claim thereto that the undersigned may have against any host parish, St. Rose of Lima Young Adults' Group, its officers, and its individual members, as a result of any and all activities, functions, outings, and other social events of every nature, type, and description whatsoever, and agrees to hold any host parish, St. Rose of Lima Young Adults' Group, its officers, and its individual members harmless from anyand all cost, damage, expense, or liability resulting from any such claim.

Membership Registration and Renewal Form

St. Rose of Lima Young Adults Group Membership Application and Renewal Form

St. Rose of Lima Young Adults Group
Membership Application and Renewal Form