********************Please Note *****************
 Your registration is NOT complete until we have received payment and the checked "I
 Agree" box for the Minor Release through Vanco. Please follow instructions on your
 confirmation email after you complete this form.

Click Submit Form to send this information to San Antonio Church.

*Required fields

Instructions Tuition Fees (does not include retreat fees):
  Confirmation 1 - $190
  Confirmation 2 - $190
  SALT - $120

Student 1
*First Name *Last Name
  Middle Name   Nickname *Mother's Maiden
*Birth Date *Gender Female   Male
*High School
*School Grade
*T-Shirt Size
Sacraments   Name Received Date Place
*Baptism
*First Comm
*Class Choices
*Class 1
Student Medical History
  Allergies/Health
  Special Needs
  Medications Taking

Emergency Contact/NOT A PARENT
*First Name *Last Name Suffix
  Relationship
Emergency Phone Numbers
*Primary Phone ( ) - Unlisted
  Other Phone ( ) - Unlisted

*Family Information  New Family Information  Update Existing Family Information ID/Env:  

Head of Household
*First Name *Last Name
*Relationship
*Gender Female   Male
  Religion Marital Status
*Primary Phone ( ) - Unlisted
*Primary Email   Unlisted

Spouse
  First Name   Last Name
Relationship
  Gender Female   Male
  Religion Marital Status
  Primary Phone ( ) - Unlisted
  Primary Email   Unlisted

Family Street Address
*Address
*City
*State
*ZIP

Family Phone Numbers
*Primary Phone ( ) - Unlisted
  Other Phone ( ) - Unlisted
Family Email Address
*Primary Email   Unlisted
Additional Remarks
  Remarks


Click Submit Form to send this information to San Antonio Church.