2026 Summer Program Registration Form

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This summer St. Mary, Marion will offer a Summer Enrichment program for children from K-8 grades.

Place: St Mary Church basement, 251 N Main St., Marion OH 43302

Welcome...

Today's date *

YYYY

Child's first and last name

Child's age *

Child's date of birth *

YYYY

Child's T-shirt size

School name and Last school grade completed: *

Name of the parent(s):

Street address, City, State and ZIP

Parent/caregiver's cell phone:

Parent/caregiver's email:

Do we have permission to take your child's picture and post it on our website?

Yes

Clear selection

Allergies or other medical conditions:

Does your child know how to swim?

yes

Clear selection

Can your child wear a lifejacket in the pool?

yes

Clear selection

In case of an emergency, contact information:

Relationship to child:

Signature of parent or guardian (Type your name):

Submit

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