2016 - 2017 St. Jarlath School Registration
Each year in February/March, pre-registration for all returning students takes place. Parents/Legal guardians pay a non-refundable registration fee of $350 to reserve a place for their student/students for the next year. 

Early registration insures that students currently enrolled have the first opportunity to register for the next school year. Those families that do not contact the school or pay the registration fee by the due date will be put on the waiting list for the following year.

Please only do one registration per student
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Child's Last Name *
Child's First Name *
Child's Middle Name *
Street Address or Apt/Suite *
Street Address Line 2
City *
State *
Zip Code *
Male or Female *
Date of Birth *
Grade for 2016 - 2017 School Year *
Mother/Father/Guardians *
Mother/Father/Guardians Home Phone *
Mother/Father/Guardians Day Phone *
Mother/Father/Guardians Email *
Living Arrangement *
Emergency Contact #1 (Name, Phone, Phone Type, Relationship) *
Emergency Contact #2 (Name, Phone, Phone Type, Relationship) *
Emergency Contact #3 (Name, Phone, Phone Type, Relationship) *
Emergency Contact #4 (Name, Phone, Phone Type, Relationship) *
Doctor *
Doctor's Phone Number *
Dentist *
Dentist Phone Number *
Medical Insurance Carrier *
Medical Insurance ID Number *
Please List any of the following: Current medications, medication allergies, food allergies, or chronic health concerns
Religious Belief *
If Non-Catholic, please specify your religious belief
If Catholic, please specify what parish do you belong to?
Race *
Required
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