StAY Program Registration for the 2016-2017 Academic Year

Name of Youth Participant *
Name of Youth Participant
Date of Birth*
Date of Birth*
If you are not Catholic, would you like to receive information about becoming Catholic?
Name of Parent/Guardian #1 *
Name of Parent/Guardian #1
Please place and “x” next to one of these two statements. *

In addition to this Registration Form, all activities taking place off campus from Saint Aloysius Parish will require separate permission forms.

If you have any questions in regard to this registration form, please contact Father Steve Paolino at