HOLY NAME
CATHOLIC CHURCH

Facebook YouTube

Registration

- The maximum number of form submissions has been reached. This form is currently not available.
  
  Today's Date REQUIRED Please fill out this field. Please enter valid data.
  
  Registered parishioner of Holy Name Catholic Church REQUIRED Yes No Please fill out this field.
  
  Family Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Student #1
  
  First and Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birth Date REQUIRED Please fill out this field. Please enter valid data.
  
  Grade for 2021-2022 REQUIRED Please fill out this field. Please enter valid data.
  
  Student #2
  
  First and Last Name Please enter valid data.
  
  Grade for 2021-2022 Please enter valid data.
  
  Birth Date Please enter valid data.
  
  Student #3
  
  First and Last Name Please enter valid data.
  
  Birth Date Please enter valid data.
  
  Grade for 2021-2022 Please enter valid data.
  
  Student #4
  
  First and Last Name Please enter valid data.
  
  Birth Date Please enter valid data.
  
  Grade for 2021-2022 Please enter valid data.
  
  Aftercare REQUIRED Yes No Please fill out this field.
  
  Aftercare days (pick all that apply) Monday Tuesday Wednesday Thursday Friday
  
  Name of person responsible for tuition payments REQUIRED Please fill out this field. Please enter valid data.
  
  Mom's phone number Please enter valid data.
  
  Dad's phone number Please enter valid data.
  
  Mailing Address REQUIRED Please fill out this field.
  
  Submit
  
  This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
- Click here for the tuition and payment information form. This form must be completed and returned to process your child's school registration. If you search the internet you will find numerous ways to fill in this pdf online. You can then submit it by email.