Saint Demetrios Greek Afternoon School Student Registration Form
Child's First Name, Last *
AGE *
Select Grade *
Days *
Monday and Wednesday Only
Saturday School Only
Child (ren) resides wtih: *
Mother
Father
Both Parents
Mother's First name *
Mother's Last name *
Address *
City / State *
Work Phone *
Home Phone *
Cell Phone *
Email *
Occupation *
Father's First Name *
Father's Last Name *
Address *
City / State *
Work Phone *
Home Phone *
Cell Phone *
Email *
Occupation *
Emergency Contact Name *
Relationship *
Home Phone *
Cell Phone *
Emergency Contact Name *
Relationship *
Home Phone *
Cell Phone *
Food Allergies (Doctor's Note Required)
Activity Restriction and / or of a Person