Soul Surfing Mondays

Parent or Guardian Name REQUIRED Please fill out this field. Please enter valid data.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Email REQUIRED Please fill out this field. Please enter an email address.

Number of Children Attending REQUIRED Please fill out this field.
Child 1
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Grade entering in Fall of 2023 REQUIRED Pre-school Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade Please fill out this field.
- My child is allergic to: Please enter valid data.
- In case of emergency notify: REQUIRED Please fill out this field. Please enter valid data.
- Emergency contact phone number: REQUIRED Please fill out this field. Please enter valid data.
Child 2
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Grade entering in Fall of 2023 REQUIRED Pre-school Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade Please fill out this field.
- My child is allergic to: Please enter valid data.
- In case of emergency notify: REQUIRED Please fill out this field. Please enter valid data.
- Emergency contact phone number: REQUIRED Please fill out this field. Please enter valid data.
- Permission for Pictures of Children/Youth:
  We may take pictures of activities that involve your child/children. These pictures may be published in the bulletin or posted on the parish bulletin board, parish Facebook or parish website. (Names will not be used.)
Child 3
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Grade entering in Fall of 2023 REQUIRED Pre-school Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade Please fill out this field.
- My child is allergic to: Please enter valid data.
- In case of emergency notify: REQUIRED Please fill out this field. Please enter valid data.
- Emergency contact phone number: REQUIRED Please fill out this field. Please enter valid data.
- Permission for Pictures of Children/Youth:
  We may take pictures of activities that involve your child/children. These pictures may be published in the bulletin or posted on the parish bulletin board, parish Facebook or parish website. (Names will not be used.)
Child 4
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Grade entering in Fall of 2023 REQUIRED Pre-school Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade Please fill out this field.
- My child is allergic to: Please enter valid data.
- In case of emergency notify: REQUIRED Please fill out this field. Please enter valid data.
- Emergency contact phone number: REQUIRED Please fill out this field. Please enter valid data.
- Permission for Pictures of Children/Youth:
  We may take pictures of activities that involve your child/children. These pictures may be published in the bulletin or posted on the parish bulletin board, parish Facebook or parish website. (Names will not be used.)

Permission for Pictures of Children/Youth:
We may take pictures of activities that involve your child/children. These pictures may be published in the bulletin or posted on the parish bulletin board, parish Facebook or parish website. (Names will not be used.)

I give my permission to use my child's/children's pictures in the capacity stated above. REQUIRED Yes No Please fill out this field.

St Mark Evangelist Catholic Community

7296 Gale Road Grand Blanc, MI
810-636-2216

7296 Gale Road
Goodrich/Grand Blanc, MI

Soul Surfing Mondays