• Please use this form to regster your child for our special needs program
  Use one form per child

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  • Parent/Guardian First and Last Name(s) REQUIRED Please fill out this field. Please enter valid data.
  • Street Address or P.O. Box REQUIRED Please fill out this field. Please enter valid data.
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  • Child's Name REQUIRED Please fill out this field. Please enter valid data.
  • Child's Age REQUIRED Please fill out this field. Please enter valid data.
  • Grade child is entering REQUIRED Please fill out this field. Please enter valid data.
  • Any information you feel we will need to help your child grow in Faith REQUIRED Please fill out this field.
  • Any information that YOU need to help your child. We are here for you!
  • Registered member of St Therese, Granby REQUIRED Yes No Please fill out this field.

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