Holy Name of Mary Student Registration |

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Student Registration

Please complete our Student Registration form for the 2022 school year.

Student First Name*
Student Last Name*
Student Grade*
Additional Student First Name
Additional Student Last Name
Additional Student Grade
Parent Information
Parent Name 1*
First Last
Email*
Home Phone
Cell Phone
Parent Name 2
First Last
Email
Home Phone
Cell Phone
Emergency Contact
Contact First Name*
Contact Last Name*
Contact Phone*
Location Information
Address*
Street Address Address Line 2 City Province Postal Code
Major Intersection*
Additional Comments