TEEN RELIGIOUS EDUCATION

REGISTRATION FORM

After completing this registration form please mail or bring the $30.00 (for each course selected) registration fee to the church office.  Make checks payable to St. Augustine Church.

Name 

Address

Street  City 

State     Zip 

Home Phone

Student's Cell Phone

Email 

Grade

School Attending 

Birthday

Age

Parents Names:

Dad's e-mail Dad's Cell

Mom's e-mail Mom's Cell