• General Information Forms 

  • SUMMER CAMP WELCOME LETTER 2023
  • TEEN HELPER REGISTRATION FORM 2023
• 
• The maximum number of form submissions has been reached. This form is currently not available.

  • Monday, June 26th - Friday, June 30th 
    Grades: K-5
    (9:00am-12:00pm)
    
    Please Complete the Entire Form and Hit the Submit Button
    
    
    For Additional Information Contact
    Barbara Dennis  (973) 948-3185 x3
  • • Number of Children to Register For CSC REQUIRED Please fill out this field.
    • Child 1
      • Child's First Name REQUIRED Please fill out this field. Please enter valid data.
      • Child's Last Name REQUIRED Please fill out this field. Please enter valid data.
      • Gender REQUIRED (Select One) Male Female Please fill out this field.
      • Child's Age REQUIRED (Select One) 4 5 6 7 8 9 10 11 12 Please fill out this field.
      • Date of Birth REQUIRED Please fill out this field. Please enter a date.
      • Grade Entering Into in Septemeber REQUIRED (Select One) K 1 2 3 4 5 Please fill out this field.
    • Child 2
      • Child's First Name REQUIRED Please fill out this field. Please enter valid data.
      • Child's Last Name REQUIRED Please fill out this field. Please enter valid data.
      • Gender REQUIRED (Select One) Male Female Please fill out this field.
      • Child's Age REQUIRED (Select One) 4 5 6 7 8 9 10 11 12 Please fill out this field.
      • Date of Birth REQUIRED Please fill out this field. Please enter a date.
      • Grade Entering Into in Septemeber REQUIRED (Select One) K 1 2 3 4 5 Please fill out this field.
    • Child 3
      • Child's First Name REQUIRED Please fill out this field. Please enter valid data.
      • Child's Last Name REQUIRED Please fill out this field. Please enter valid data.
      • Gender REQUIRED (Select One) Male Female Please fill out this field.
      • Child's Age REQUIRED (Select One) 4 5 6 7 8 9 10 11 12 Please fill out this field.
      • Date of Birth REQUIRED Please fill out this field. Please enter a date.
      • Grade Entering Into in Septemeber REQUIRED (Select One) K 1 2 3 4 5 Please fill out this field.
    • Child 4
      • Child's First Name REQUIRED Please fill out this field. Please enter valid data.
      • Child's Last Name REQUIRED Please fill out this field. Please enter valid data.
      • Gender REQUIRED (Select One) Male Female Please fill out this field.
      • Child's Age REQUIRED (Select One) 4 5 6 7 8 9 10 11 12 Please fill out this field.
      • Date of Birth REQUIRED Please fill out this field. Please enter a date.
      • Grade Entering Into in Septemeber REQUIRED (Select One) K 1 2 3 4 5 Please fill out this field.
    • Child 5
      • Child's First Name REQUIRED Please fill out this field. Please enter valid data.
      • Child's Last Name REQUIRED Please fill out this field. Please enter valid data.
      • Gender REQUIRED (Select One) Male Female Please fill out this field.
      • Child's Age REQUIRED (Select One) 4 5 6 7 8 9 10 11 12 Please fill out this field.
      • Date of Birth REQUIRED Please fill out this field. Please enter a date.
      • Grade Entering Into in Septemeber REQUIRED (Select One) K 1 2 3 4 5 Please fill out this field.
  • Parent's Name REQUIRED Please fill out this field. Please enter valid data.
  • City REQUIRED Please fill out this field. Please enter valid data.

    State REQUIRED AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY Please fill out this field.

    Zip REQUIRED Please fill out this field. Please enter a zip code.
  • Parent's Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  • Home Phone Number Maximum 20 characters Please enter a phone number.
  • Parent's Email REQUIRED Please fill out this field. Please enter an email address.
  • Home Parish REQUIRED Please fill out this field. Please enter valid data.
  • I would Like to Volunteer at the Summer Camp Yes, I would Like to Help No Thanks
  • I give permission for the Church to use photo(s) of my child(ren) to be used in the church bulletin, parish publications, parish website and Diocesan publication, "The Beacon".  I give Permission I do not give Permission
  • Medical and Emergency Information:
  • Allergies or Other Medical Conditions:
  • Name of Emergency Contact: REQUIRED Please fill out this field. Please enter valid data.
  • Emergency Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  • Emergency Home Phone Number Maximum 20 characters Please enter a phone number.
  • Emergency Email Please enter an email address.
  • Relationship to Child REQUIRED Please fill out this field. Please enter valid data.

  Submit

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