St. Vincent de Paul Parish

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REGISTER FOR wednesday SESSION
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- Home Phone Number Please enter a phone number.
- Family Information
  
  Main Contact Email REQUIRED Please fill out this field. Please enter an email address.
  
  Marital Status REQUIRED Please fill out this field.
  
  Child(ren) live with REQUIRED Please fill out this field.
- Mother's Information or Legal Guardian
  
  If legal guardian please indicate relationship Please enter valid data.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  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
  email you want notices sent to
  Please fill out this field. Please enter an email address.
  
  Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Custodial Parent? REQUIRED Please fill out this field.
- Father's Information or Legal Guardian
  
  If legal guardian please indicate relationship Please enter valid data.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Address (if different from mother) Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Home Phone Number Please enter a phone number.
  
  Custodial Parent? REQUIRED Please fill out this field.
- Number of Students Registering REQUIRED Please fill out this field.
  
  Student 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birth Date (must be 3 years old by September 1st) REQUIRED Please fill out this field. Please enter a date.
  
  Medical or Educational Concerns? REQUIRED Please fill out this field.
  
  Student 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birth Date (must be 3 years old by September 1st) REQUIRED Please fill out this field. Please enter a date.
  
  Medical or Educational Concerns? REQUIRED Please fill out this field.
  
  Student 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birth Date (must be 3 years old by September 1st) REQUIRED Please fill out this field. Please enter a date.
  
  Medical or Educational Concerns? REQUIRED Please fill out this field.
  
  Student 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birth Date (must be 3 years old by September 1st) REQUIRED Please fill out this field. Please enter a date.
  
  Medical or Educational Concerns? REQUIRED Please fill out this field.
  
  Student 5
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birth Date (must be 3 years old by September 1st) REQUIRED Please fill out this field. Please enter a date.
  
  Medical or Educational Concerns? REQUIRED Please fill out this field.
  
  Student 6
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birth Date (must be 3 years old by September 1st) REQUIRED Please fill out this field. Please enter a date.
  
  Medical or Educational Concerns? REQUIRED Please fill out this field.
- Permission to use my child's photo in church bulletin /website REQUIRED yes, I give my permission no, I do not give my permission Please fill out this field.
- Volunteer Opportunities - Please check if you can help in any of the following programs: Carpenters/Crafters to create Atrium Volunteers to assist in Atrium
- The registration fee is $15 per child. You may pay online by selecting pay now or send check/cash payment by selecting pay later.
  
  If you need financial assistance please contact the parish office.
- Fee: REQUIRED Please fill out this field.
- PLEASE NOTE: If you missed filling in any of the required sections, after you press "Submit" a notice in red will appear prompting you to fill in incomplete sections. Once the form is properly completed and "Submit" is clicked, you will receive a confirmation email along with information on how to order your books.
  
  If you have any questions or feedback, please contact P ip Donohoe or comment below.
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- Formation