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  • Please enter CHILD'S information below.
  • First Name REQUIRED Please fill out this field. Please enter valid data.

    Last Name REQUIRED Please fill out this field. Please enter valid data.
  • Date of Birth REQUIRED Please fill out this field. Please enter a date.
  • Current Grade in School REQUIRED Please fill out this field. Please enter valid data.
  • Baptism Date REQUIRED Please fill out this field. Please enter valid data.
  • Parish of Baptism REQUIRED Please fill out this field. Please enter valid data.
  • Parish Street Address REQUIRED Please fill out this field. Please enter valid data.
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    State REQUIRED AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY Please fill out this field.

    Zip REQUIRED Please fill out this field. Please enter a zip code.
  • Please enter PARENT/GUARDIAN information below.
  • FATHER
  • First Name REQUIRED Please fill out this field. Please enter valid data.

    Last Name REQUIRED Please fill out this field. Please enter valid data.
  • Email REQUIRED Please fill out this field. Please enter an email address.
  • MOTHER
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    Last Name REQUIRED Please fill out this field. Please enter valid data.
  • Email REQUIRED Please fill out this field. Please enter an email address.
  • MAILING ADDRESS
  • Street Address REQUIRED Please fill out this field. Please enter valid data.
  • City REQUIRED Please fill out this field. Please enter valid data.

    State REQUIRED AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY Please fill out this field.

    Zip REQUIRED Please fill out this field. Please enter a zip code.
  • Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.

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