SS Peter & Paul School
Children Are Receiving Extended Services
C.A.R.E.S. Program
Registration Form 2011-2012
Family Name ________________________________________________
Mother’s name _______________________________________________
Cell #:__________________________ Work #:____________________________
Father’s name ________________________________
Cell #:__________________________ Work #:____________________________
Child’s first name Grade
________________________________ ____________________
________________________________ ____________________
________________________________ ____________________
________________________________ ____________________
The days of the week that I intend my child(ren) to attend at this time:
_____ Monday _____ Tuesday _____Wednesday_____Thursday _____Friday
***Please print, complete and return this form along with your family’s $50 non-refundable
registration fee. Thank you for your interest in the C.A.R.E.S. Program!