Registration: Just5Days 2019

Please complete a separate registration for each individual.
Email address *
Please check the box that applies: *
Participant First and Last Name *
Your answer
Parent/Adult First & Last Name *
Your answer
Parent/Adult Phone Number *
Your answer
Address: *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Participant current grade in school *
Would you like to sign up for Just5Days 2019? *
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: Rebecca Moczulewski
9520 W. Forest Home Ave.
Hales Corners, WI. 53130

A copy of your responses will be emailed to the address you provided.
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