What program would you like to register your child for? *
Choose
Junior EDGE (grades 1-4) on the 2nd & 4th Mondays of the month
EDGE (grades 5-8) on the 2nd & 4th Fridays of the month
Child's Current School *
Choose
St. Bernadette CES
St. James CES
St. Teresa of Calcutta CES
Other Catholic Elementary School
Other Public Elementary School
Homeschool
Has your child been baptized in the Catholic Church? *
If your child has any allergies, please indicate what they are, or simply write "none"
Your answer
Does your child carry an EpiPen?
Clear selection
Please advise our Youth Coordinator of any of your child's health concerns or special needs:
Your answer
Child's current home address *
Your answer
Mother's full name
Your answer
Mother's phone number
Your answer
Mother's email
Your answer
Father's full name
Your answer
Father's phone number
Your answer
Father's email
Your answer
Please indicate all individuals who will be picking up your child from EDGE/Jr. EDGE *
Your answer
Do you consent to have photographs/videos of your child taken during EDGE/Jr. EDGE Nights for the use in any form of media and/or publicity material produced or printed by St. Bernadette Parish or other appropriate partners. *