Young Family Email Registration

Family Last Name REQUIRED Please fill out this field. Please enter valid data.

Father's Name Please enter valid data.

Father's Email Address Please enter valid data.

Father's Phone Number Please enter valid data.

Mother's Name Please enter valid data.

Mother's Email Please enter valid data.

Mother's Phone Number Please enter valid data.

We are parishioners of REQUIRED Our Lady of Perpetual Help Parish St. Matthew Parish Saints Martha & Mary Parish Christ the King Parish Other - Please list in text box below Please fill out this field.

Name of "Other" parish Please enter valid data.

Number of Children REQUIRED Please fill out this field.
Child 1
- Child's Full Name Please enter valid data.
- Gender Male Female
- Date of Birth Please enter valid data.
- Grade Please enter valid data.
Child 2
- Child's Full Name Please enter valid data.
- Gender Male Female
- Date of Birth Please enter valid data.
- Grade Please enter valid data.
Child 3
- Child's Full Name Please enter valid data.
- Gender Male Female
- Date of Birth Please enter valid data.
- Grade Please enter valid data.
Child 4
- Child's Full Name Please enter valid data.
- Gender Male Female
- Date of Birth Please enter valid data.
- Grade Please enter valid data.
Child 5
- Child's Full Name Please enter valid data.
- Gender Male Female
- Date of Birth Please enter valid data.
- Grade Please enter valid data.
Child 6
- Child's Full Name Please enter valid data.
- Gender Male Female
- Date of Birth Please enter valid data.
- Grade Please enter valid data.

Our Lady of Perpetual help

St. Mary of the Assumption &
St. Ursula Churches

Young Family Email Registration