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C.A.R.E.S. Registration

- Current Families

2021/2022 C.A.R.E.S. Registration
The maximum number of form submissions has been reached. This form is currently not available.
- Any St. James Regional family is eligible to register for the C.A.R.E.S. program at any point during the school year. To ensure the safety and well-being of your child, families must complete this form before they can use the C.A.R.E.S. program. Thank you for your support!
- Family Name REQUIRED Please fill out this field. Please enter valid data.
- Street REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Email REQUIRED Please fill out this field. Please enter valid data.
- Child's Information
  
  Child's Name 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.
  
  Mother's Contact Information (Name/Email/Cell, Home & Work #'s) REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Contact Information (Name/Email/Cell, Home & Work # REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Pick-up (Other than parents) Names & Phone #'s REQUIRED Please fill out this field.
- Medical Information: (Example- Allergies) REQUIRED Please fill out this field.
- Child's Information
  
  Child's Name Please enter valid data.
  
  Date of Birth Please enter valid data.
  
  Age Please enter valid data.
  
  Grade Please enter valid data.
  
  Mother's Contact Information (Name/Email/Cell, Home & Work #'s) Please enter valid data.
  
  Father's Contact Information (Name/Email/Cell, Home & Work # Please enter valid data.
  
  Emergency Pick-up (Other than parents) Names & Phone #'s
- Medical Information: (Example- Allergies)
- Child Information
  
  Child's Name Please enter valid data.
  
  Date of Birth Please enter valid data.
  
  Age Please enter valid data.
  
  Grade Please enter valid data.
  
  Mother's Contact Information (Name/Email/Cell, Home & Work # Please enter valid data.
  
  Father's Contact Information (Name/Email/Cell, Home & Work # Please enter valid data.
  
  Emergency Pick-up (Other than parents) Names & Phone #'s Please enter valid data.
- Medical Information: (Example- Allergies) Please enter valid data.
- Registration Fee REQUIRED Please fill out this field.
Total:

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