Saint Mark’s Youth Registration Form

School Year

Date (MM/DD/YYYY)

Name of Parent(s)/Guardian(s)

Address

Street Address

Address Line 2

City

State

Postal / Zip Code

Country

Phone Number

Cell Phone Number (optional)

Email (optional)

Preferred Communication

Child's Name

Date of Birth (MM/DD/YYYY)

Age

Grade

Additional Information (allergies, other health concerns, etc.)

Second Child's Name

Date of Birth (MM/DD/YYYY)

Age

Grade

Additional Information (allergies, other health concerns, etc.)

Third Child's Name

Date of Birth (MM/DD/YYYY)

Additional Information (allergies, other health concerns, etc.)

Age

Grade

Additional Information (allergies, other health concerns, etc.)

I am willing to:

Chaperone

Assist with BIG EVENT!

Did you remember to:

Fill-out a Health and Wellness form and Media-release form (to register your preferences on the use of photography) for each child enrolled above?

You can find the Health and Wellness form by clicking here

You can find the Media-Release form by clicking here

Don't forget to register with "Join Our Email" for important parish updates and information.