2025 Youth Rally Volunteer Registration Form Name(Required) First Last Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Cell Phone Number:(Required)Email(Required) Date of Birth:(Required)Gender:(Required)Select your Parish from the list below:(Required)Select your ParishChrist the King Parish – ArchbaldSaint Leo Parish – AshleyQueen of the Apostles Parish – AvocaSaint Elizabeth Parish – Bear CreekOur Lady Queen of Peace Parish – BrodheadsvilleSaint Michael Parish – CantonOur Lady of Mt. Carmel Parish – CarbondaleSaint Rose of Lima Parish – CarbondaleSaint Frances X. Cabrini Parish – CarvertonSaint Gregory Parish – Clarks GreenOur Lady of the Snows Parish – Clarks SummitSaint John Bosco Parish – ConynghamMost Holy Trinity Parish – CrescoGate of Heaven Parish – DallasOur Lady of the Abingtons Parish – DaltonVisitation of the B.V.M. Parish – Dickson CityGood Shepherd Parish – DrumsOur Lady of Mount Carmel Parish- DunmoreSaints Anthony & Rocco Parish – DunmoreSacred Heart of Jesus Parish – DupontNativity of Our Lord Parish – DuryeaImmaculate Heart of Mary Parish – DushoreSaint John Parish – East StroudsburgSaint Matthew Parish – East StroudsburgSaint Thomas the Apostle Parish – ElklandSaint Barbara Parish – ExeterAscension Parish – Forest CityOur Lady of the Immaculate Conception Parish – FreelandSaint Brigid Parish – FriendsvilleHoly Spirit Parish – Glen LyonSaint Rita Parish – GouldsboroExaltation of the Holy Cross Parish – Hanover Twp.Our Lady of Victory Parish – Harveys LakeBlessed Virgin Mary, Queen of Peace Parish – HawleySaint John Neumann Parish – HawleySaint Pius of Pietrelcina – HazletonHoly Rosary Parish – HazletonOur Lady of Peace Parish – HazletonQueen of Heaven Parish – HazletonSaints Cyril & Methodius Parish – HazletonSaint John the Evangelist Parish – HonesdaleOur Lady of Mt. Carmel Parish – Hunlock CreekSacred Hearts of Jesus and Mary Parish – JermynSaint Luke Parish – Jersey ShoreQueen of Angels Parish – JessupSaint Ignatius Loyola Parish – KingstonSaint Maria Goretti Parish – LaflinSaint Thomas More Parish – Lake ArielSaint Mary of the Lake Parish – Lake WinolaSaint John the Baptist Parish – LarksvilleHoly Family Parish – LuzerneHoly Child Parish – MansfieldSaint Joseph Parish – MatamorasSaint Patrick Parish – MilfordSaint Vincent de Paul Parish – MilfordSaint John Vianney Parish – Scott TownshipOur Lady of Lourdes Parish – MontoursvilleHoly Name of Mary Parish – MontroseSaint Catherine of Siena Parish – MoscowSaint Jude Parish – Mountain TopResurrection Parish – MuncySaint Faustina Kowalska Parish – NanticokeSaint Patrick Parish – NicholsonPrince of Peace Parish – Old ForgeBlessed Carlo Acutis Parish – OlyphantSacred Heart of Jesus Parish – PeckvilleSaint Joseph Marello Parish – PittstonOur Lady of the Eucharist Parish – PittstonSaint John the Evangelist Parish – PittstonSaints Peter & Paul Parish – PlainsSaint Katharine Drexel Parish – Pleasant MountAll Saints Parish – PlymouthSaint Maximilian Kolbe Parish – Pocono PinesSaint Eulalia Parish – Roaring Brook TownshipEpiphany Parish – SayreCathedral of Saint Peter – ScrantonDivine Mercy Parish – ScrantonMary, Mother of God Parish – ScrantonImmaculate Conception Parish – ScrantonSaint John Neumann Parish – ScrantonSaint Ann Basilica Parish – ScrantonSaint Lucy Parish – ScrantonSaints Peter & Paul Parish – ScrantonSaint Patrick Parish – ScrantonSaint Paul Parish – ScrantonSaint Paul of the Cross Parish – ScrantonSaint Therese Parish – ShavertownSaint Ann Parish – ShoholaSaint Lawrence Parish – South WilliamsportSaint Luke Parish – StroudsburgHoly Family Parish – Sugar NotchMost Holy Trinity Parish – SusquehannaSaint Elizabeth Ann Seton Parish – SwoyersvilleOur Lady of Victory Parish – TannersvilleBlessed Sacrament Parish – ThroopSaints Peter and Paul Parish – TowandaNativity of the B.V.M. Parish – TunkhannockOur Lady Help of Christians Parish – WapwallopenSaint Mary Parish -WaymartSaint Peter Parish – WellsboroHoly Name of Jesus Parish – West HazletonSacred Heart of Jesus Parish – WestonCorpus Christi Parish – West PittstonSaint Monica Parish – West WyomingSaint Patrick Parish- White HavenOur Lady of Fatima Parish- Wilkes-BarreOur Lady of Hope Parish- Wilkes-BarreSaint Andre Bessette Parish- Wilkes-BarreSaint Andrew Parish – Wilkes-BarreSaint Benedict Parish- Wilkes-BarreSaint Nicholas Parish- Wilkes-BarreSaint Robert Bellarmine Parish- Wilkes-BarreImmaculate Conception of the B.V.M. Parish – WilliamsportSaint Ann Parish – WilliamsportSaint Boniface Parish – WilliamsportSaint Joseph the Worker Parish – WilliamsportOur Lady of Perpetual Help Parish – WyalusingT-SHIRT SIZE (Adult Unisex Size) S M L XL 2X 3X 4X Dietary Needs/Allergies/MedicalPlease confirm:(Required) I certify that I am Safe Environment complaint, and my clearance are on file at my parish or at the Diocese of Scranton. I understand that my Safe Environment status will be verified. I understand that I will be held to the same Code of Conduct as the Chaperone of this event as it been explained in the links below. Code of Conduct FormFormulario de Código de Conducta de AcompañanteEmergency Contact First Last Relationship to Volunteer:PhoneEmail Volunteer History (Please list your last three volunteer activities, starting with the most recent.)In what area would you like to serve?Personal References1. Primary Reference First Last Email Phone2. Secondary Reference First Last Email Phone Δ
