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PSR Registration

January 4, 2022 | ,

PSR Registration

PreK-12th Registration – This includes all Sacrament classes and Teen Enrichment.

"*" indicates required fields

Parent Name*
Parent Name
Address*
The doctor to contact in case of emergency.
Hospital*

If we are unable to contact you in case of an emergency, who should be contacted next?
Child #1*
Name
Grade Level
Date of Birth
Medication, Allergies, and Medical Concerns
 
Child #1 has COMPLETED:*
Child #2
Skip to the bottom if you have no more children to register.
Name
Grade Level
Date of Birth
Medication, Allergies, and Medical Concerns
 
Child #2 has COMPLETED:
Child #3
Skip to the bottom if you have no more children to register.
Name
Grade Level
Date of Birth
Medication, Allergies, and Medical Concerns
 
Child #3 has COMPLETED:
Child #4
Skip to the bottom if you have no more children to register.
Name
Grade Level
Date of Birth
Medication, Allergies, and Medical Concerns
 
Child #4 has COMPLETED:
Consent*
By typing in your name you are verifying you completed this form and your name acts as your “eSignature.”
This field is for validation purposes and should be left unchanged.