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  • Family Name, Mother's First , Father's First REQUIRED Please fill out this field. Please enter valid data.
  • Address: Street, City, Zip Please enter valid data.
  • Phone: Please enter valid data.
  • Is it ok to text? REQUIRED Yes No Please fill out this field.
  • Email: Please enter valid data.
  • Do you check this email daily? Yes No
  • Mother's Religion Please enter valid data.
  • Father's Religion Please enter valid data.
  • Does your family attend Mass weekly? Yes No
  • Are you a registered member of St. Joseph Parish, Watervliet? Yes No
  • If you are not a member of St. Joseph, Watervliet, there is a $25 fee per child. Checks can be made payable to St. Joseph Parish.
  • Child's name (include last name if different) REQUIRED Please fill out this field. Please enter valid data.
  • Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  • Age REQUIRED Please fill out this field. Please enter valid data.
  • Grade REQUIRED Please fill out this field. Please enter valid data.
  • Year and Parish of Baptism* REQUIRED Please fill out this field. Please enter valid data.
  • Has this child received First Communion? REQUIRED Yes No Please fill out this field.
  • Please list any learning problems, medical alerts, or allergies of children that our staff should know about:
  • Please list an emergency contact person in case either parent mentioned above is not available. Please provide: First and last name, phone number and relationship. REQUIRED Please fill out this field.

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