Sample signup form (for demonstration only)

Name      
e-mail address      
Address
Addr_2 
City
State Zip Phone

Number of children in family          
Names of those attending program
   Age       Confirmed? Yes
   Age       Confirmed? Yes
   Age       Confirmed? Yes
   Age       Confirmed? Yes
   Age       Confirmed? Yes
   Age       Confirmed? Yes
Check if more names below under "Comments"

Name(s) of parent(s) attending

How many will eat meal? 

Family will (check one)   Stay only for program     Help with dishes     Eat and run

Check this box if you are not willing for photos of your children to be used in St. Lucy literature or on the web site.  (All photos of children will appear unidentified.)

Comments (e.g. accessibility requirements) or additional names

OR use the print function to print this filled-in form; submit it in the collection basket or the rectory mail slot.