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Extended Care Registration
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Extended Care Registration
Extended Care Registration Form (Kindergarten-Grade 8)
Step 1 of 4
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Name of Child
*
First
Last
Date
Time
:
HH
MM
AM
PM
Father's Name
*
First
Middle
Last
Father's Phone
Father's Email
*
Enter Email
Confirm Email
Father's Work Phone
Mother's Name
*
First
Middle
Last
Mother's Phone
*
Mother's Email
*
Enter Email
Confirm Email
Mother's Work Phone
Are you a active member of St. Mary Parish?
*
Yes
No
Method of Payment?
*
Check
Cash
Please make payment at the school office.
Notes or suggestions regarding your child.
Name
This field is for validation purposes and should be left unchanged.