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PLEASE COMPLETE THE FORM BELOW TO SIGN UP FOR ST. JOSEPH YOUTH MINISTRY
Contact Us
Name of Child:
Date of Birth:
Grade:
Address:
Parish Child Belongs To:
Parent/Guardian Name
Parent/Guardian Cell Number:
Best Email to Use for Communication:
Emergency Contact Person:
Relationship to Emergency Contact Person:
Emergency Contact Cell Number:
School Child Attends:
Allergies to Medication/Food:
Does the child carry medication with them or epi-pen?
No
Yes
Does your child have special needs that we need to be made aware of?
Is there someone who MAY NOT transport your child home? List their name below.
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Contact Us
59 Main Street
High Bridge, NJ 08829
Phone:
908-638-6211
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