Extended Care Registration

Extended Care Registration Form (Kindergarten-Grade 8)

Step 1 of 4

25%

Name of Child*
First Last
Date
Time

: HH

MM

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Father's Name*
First Middle Last
Father's Phone
Father's Email*
Enter Email Confirm Email
Father's Work Phone

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Mother's Name*
First Middle Last
Mother's Phone*
Mother's Email*
Enter Email Confirm Email
Mother's Work Phone

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Are you a active member of St. Mary Parish?*
Method of Payment?*
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.

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