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Religious Education Registration

- Religious Education Registration
  
  Parent 1*
  
  First Name * Maximum 80 characters Please fill out this field. Please enter valid data.
  
  Last Name * Maximum 80 characters Please fill out this field. Please enter valid data.
  
  Family Contact Email * Maximum 200 characters Please fill out this field. Please enter an email address.
  
  Family Phone * Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Parent 2
  
  First Name Maximum 80 characters Please enter valid data.
  
  Last Name Maximum 80 characters Please enter valid data.
  
  Email Maximum 200 characters Please enter an email address.
  
  Phone Maximum 20 characters Please enter a phone number.
  
  Emergency Contact*
  
  First Name * Maximum 80 characters Please fill out this field. Please enter valid data.
  
  Last Name * Maximum 80 characters Please fill out this field. Please enter valid data.
  
  Phone * Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  How many children are you registering? Maximum 10 characters Please enter an integer (number) from 1 to 10.
  
  Child 1*
  
  First Name * Maximum 80 characters Please fill out this field. Please enter valid data.
  
  Last Name * Maximum 80 characters Please fill out this field. Please enter valid data.
  
  Date of Birth * Maximum 20 characters Please fill out this field. Please enter a date.
  
  Registering for * Please fill out this field.
  
  Comments
  
  Child 2*
  
  First Name * Maximum 80 characters Please fill out this field. Please enter valid data.
  
  Last Name * Maximum 80 characters Please fill out this field. Please enter valid data.
  
  Date of Birth * Maximum 20 characters Please fill out this field. Please enter a date.
  
  Registering for * Please fill out this field.
  
  Comments
  
  Child 3*
  
  First Name * Maximum 80 characters Please fill out this field. Please enter valid data.
  
  Last Name * Maximum 80 characters Please fill out this field. Please enter valid data.
  
  Date of Birth * Maximum 20 characters Please fill out this field. Please enter a date.
  
  Registering for * Please fill out this field.
  
  Comments
  
  Child 4*
  
  First Name * Maximum 80 characters Please fill out this field. Please enter valid data.
  
  Last Name * Maximum 80 characters Please fill out this field. Please enter valid data.
  
  Date of Birth * Maximum 20 characters Please fill out this field. Please enter a date.
  
  Registering for * Please fill out this field.
  
  Comments
  
  Child 5*
  
  First Name * Maximum 80 characters Please fill out this field. Please enter valid data.
  
  Last Name * Maximum 80 characters Please fill out this field. Please enter valid data.
  
  Date of Birth * Maximum 20 characters Please fill out this field. Please enter a date.
  
  Registering for * Please fill out this field.
  
  Comments
  
  Child 6*
  
  First Name * Maximum 80 characters Please fill out this field. Please enter valid data.
  
  Last Name * Maximum 80 characters Please fill out this field. Please enter valid data.
  
  Date of Birth * Maximum 20 characters Please fill out this field. Please enter a date.
  
  Registering for * Please fill out this field.
  
  Comments
  
  Child 7*
  
  First Name * Maximum 80 characters Please fill out this field. Please enter valid data.
  
  Last Name * Maximum 80 characters Please fill out this field. Please enter valid data.
  
  Date of Birth * Maximum 20 characters Please fill out this field. Please enter a date.
  
  Registering for * Please fill out this field.
  
  Comments
  
  Child 8*
  
  First Name * Maximum 80 characters Please fill out this field. Please enter valid data.
  
  Last Name * Maximum 80 characters Please fill out this field. Please enter valid data.
  
  Date of Birth * Maximum 20 characters Please fill out this field. Please enter a date.
  
  Registering for * Please fill out this field.
  
  Comments
  
  Child 9*
  
  First Name * Maximum 80 characters Please fill out this field. Please enter valid data.
  
  Last Name * Maximum 80 characters Please fill out this field. Please enter valid data.
  
  Date of Birth * Maximum 20 characters Please fill out this field. Please enter a date.
  
  Registering for * Please fill out this field.
  
  Comments
  
  Child 10*
  
  First Name * Maximum 80 characters Please fill out this field. Please enter valid data.
  
  Last Name * Maximum 80 characters Please fill out this field. Please enter valid data.
  
  Date of Birth * Maximum 20 characters Please fill out this field. Please enter a date.
  
  Registering for * Please fill out this field.
  
  Comments
  
  Submit
  
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Christ the King, St. Jude Thaddeus,
& St. Paul Catholic Churches

600 DAVEY DRIVE, BURKBURNETT, Tx 76354 940-569-1222
[email protected]

Religious Education Registration

Religious Education Registration