Queen of the Holy Rosary - Wea School

22705 Metcalf RD
Bucyrus, KS 66013
913.533.2462

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Afternoon Adv Morning Enr

Afternoon Adventures - 3 Year Olds
Morning Enrichment - 4 & 5 Year Olds

Please complete the following form to register your children in these programs.
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- Parent Information
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Address 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 an email address.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Afternoon Adventures
- Afternoon Adventures Number of Students REQUIRED Please fill out this field.
  
  Student 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Days per Week - Afternoon Adv. REQUIRED Please fill out this field.
  
  Student 4
  
  Days per Week - Afternoon Adv. REQUIRED Please fill out this field.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Student 10
  
  Days per Week - Afternoon Adv. REQUIRED Please fill out this field.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Student 9
  
  Days per Week - Afternoon Adv. REQUIRED Please fill out this field.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Student 8
  
  Days per Week - Afternoon Adv. REQUIRED Please fill out this field.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Student 7
  
  Days per Week - Afternoon Adv. REQUIRED Please fill out this field.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Student 6
  
  Days per Week - Afternoon Adv. REQUIRED Please fill out this field.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Student 5
  
  Days per Week - Afternoon Adv. REQUIRED Please fill out this field.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Student 3
  
  Days per Week - Afternoon Adv. REQUIRED Please fill out this field.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Student 2
  
  Days per Week - Afternoon Adv. REQUIRED Please fill out this field.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Morning Enrichment Number of Students REQUIRED Please fill out this field.
  
  Student 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Days per Week Morning Enr. REQUIRED Please fill out this field.
  
  Student 4
  
  Days per Week Morning Enr. REQUIRED Please fill out this field.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Student 3
  
  Days per Week Morning Enr. REQUIRED Please fill out this field.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Student 2
  
  Days per Week Morning Enr. REQUIRED Please fill out this field.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Please verify information before submitting this registration form.
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