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Registration: Just5Days 2017

Please complete a separate registration for each child.
Participant First & Last Name *
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Parent First & Last Name *
Your answer
Participant Email (if none, write NONE)
Your answer
Parent Email (if none, write NONE)
Your answer
Participant Phone Number
Your answer
Parent Phone Number *
Your answer
Address: *
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City *
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State *
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Zip Code *
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Participant current grade in school *
Would you like to sign up for Just5Days 2017? *
Down payment:
Please note that registration becomes official upon receipt of $50 down payment. Make check payable to St. Mary and add Just5Days in the Notation space. Payment can be dropped off in person or mailed to:

St. Mary Catholic Faith Community
Attn: Jeff Kacala
9520 W. Forest Home Ave.
Hales Corners, WI. 53130

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