MSM Registration

In order for your child to participate in the Middle School Ministry program, you MUST register.

 

Student Information
Student's Name
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Grade entering in the fall
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Date of Birth //
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Student's Phone Number --
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Student's E-mail
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Any Allergies?
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Please list any allergies the student may have.
Family Information
Father's Name
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Father's E-mail
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Please provide us with the email of one parent.
Father's Phone Number --
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Mother's Name
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Mother's E-mail
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Mother's Phone Number --
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Parish Registration
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Preferred Contact
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Emergency Contact
Contact Name
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Name of the person to contact.
Relationship
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Tell us what the relationship is with the student (e.g. parent, legal guardian, grandparent, friend).
Contact Phone Number --
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Emergency Instructions
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What if any special instructions in the event of an emergency.