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St. Paul's Children & Youth Program Registration (2022-23)
If your child or teen will be participating in any of our drop-off programs during the 2022-23 school year please complete the following digital form to register your young person!
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* Indicates required question
Email
*
Your email
Information about the Parents & Family
Parent/Guardian #1
*
(First Name, Last Name)
Your answer
Relationship to Child(ren)
*
Choose
Mother
Father
Legal Guardian
Grandparent
Other
Parent/Guardian #1 EMAIL Address
*
Your answer
Parent/Guardian #1 Phone Number
*
Your answer
Parent/Guardian #2
(First Name, Last Name)
Your answer
Relationship to Child(ren)
Choose
Mother
Father
Legal Guardian
Grandparent
Other
Parent/Guardian #2 EMAIL Address
Your answer
Parent/Guardian #2 Phone Number
Your answer
Primary Address for the Family / Child
*
Your answer
Zip Code
Your answer
The Primary Address listed above is the address for:
*
Both Parents
Parent/Guardian #1
Parent/Guardian #2
Other:
Required
Emergency Contact
*
Please give the name of a person to contact in the event that
neither
above listed parent/guardian can be reached (we will contact parents/guardians above first):
Your answer
Emergency Contact Phone Number
*
Your answer
Emergency Contact Relationship to Child(ren)
*
Your answer
Please click the "Next" button to continue registering your child/children
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