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Fiat Registration

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  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Street Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Husband's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Names of Children with their Ages
  
  Affiliation with Holy Family REQUIRED Parishioner Holy Family Academy Parent Parishioner | Holy Family Academy Parent Non-Parishioner Please fill out this field.
  
  What days and times each week are you typically available to meet with a small group?
  
  Any medical restrictions/needs that our core leadership team should know about? REQUIRED Please fill out this field.
  
  What is one hope you have in choosing to participate in a year of FIAT? REQUIRED Please fill out this field.
  
  Do you have any speakers you are interested in hearing from or topics you are interested in hearing about that would be fitting for this group?
  
  What type of events outside of monthly meetings and small groups would you look forward to and/or prioritize attending? (For example, trivia nights, happy hours, art projects, etc.)
  
  Is there anything else our core leadership team should know about you? REQUIRED Please fill out this field.
  
  I agree my contact information may be shared with core leadership team members REQUIRED Yes No Please fill out this field.
  
  I give permission for pictures taken of me to be used in e-mails or parish communications. REQUIRED Yes No Please fill out this field.
  
  I have read and agree to abide by the FIAT handbook and expectations. REQUIRED Yes Please fill out this field.
  
  FIAT Handbook
  
  Please select a payment option REQUIRED Please fill out this field.
  
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