Open House Pre-Registration
September 20, 2026, 2-4pm St. Brendan's Church, 384 Hartford Avenue, Bellingham, MA 02019
Today's Date
*
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Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Parent Full Name
*
First Name
Last Name
Parent Email Address
*
example@example.com
Parent Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent 2 Full Name
First Name
Last Name
Parent 2 Email Address
example@example.com
Parent 2 Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Child 1 Information
Student Name (Child 1)
*
First Name
Last Name
Date of Birth (Child 1)
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Pertinent Medical Concerns (Child 1)
Food Allergies (Child 1)
Child 2 Information (if applicable)
Student Name (Child 2)
First Name
Last Name
Date of Birth (Child 2)
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Pertinent Medical Concerns (Child 2)
Food Allergies (Child 2)
Child 3 Information (if applicable)
Student Name (Child 3)
First Name
Last Name
Date of Birth (Child 3)
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Pertinent Medical Concerns (Child 3)
Food Allergies (Child 3)
Parent Permission Signature
*
Submit Registration
Submit Registration
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