St. James Religious Education Registration
Please submit one form per child
eblaine@syrdio.org (not shared) Switch account
Child's Full Name *
Child's Grade level *
School your child will be attending *
Date of Birth *
Date
Sex
Mother's Full Name and Maiden Name: please indicate Maiden name separately *
Father's Full Name *
Child's Guardian (who the child lives with) *
Mailing address for the child's place of residence *
Request a 2nd contact for child (Name/address/phone/email etc.)
Phone numbers for Parents/Guardians: please indicate home/cell/work and name for each *
Emergency Contact: name and number to call WHEN child is in Rel. Ed. event *
Medical Alert for Child: Please list all info that might help us in meeting the needs of your child: allergies, special learning needs, fears, medication, etc. *
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