PSR Registration RM_StatsParent First Name(s) *Last Name *Address State or Region AL AK AZ AR AA AE AP CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Primary Contact First Name *First name of Primary adult contact. Provide phone numbers and email in next fields.Cell Phone 1 *Cell phone for Primary contactHome Phone 1Home phone for Primary contactWork Phone 1Work phone for Primary contactPrimary E-mail *Secondary Contact First NameFirst name for Second adult contact. Provide phone numbers and email in following fields.Cell Phone 2Cell phone for Secondary contactHome Phone 2Home Phone number for Secondary contactWork Phone 2Work phone for Secondary contactSecondary EmailChild's Name *Grade *K1st2nd3rd4th5th6th7th8thGrade for 1st childSchool Name *Child's NameGradeK1st2nd3rd4th5th6th7th8thGrade for 1st childSchool NameChild's NameGradeK1st2nd3rd4th5th6th7th8thGrade for 3rd childSchool NameParish * St. John's Other Parish If you are from another parish, please name that parish below.Name of ParishPlease type name and city, state of current parish if not St. John's.CommentsIf you have anything else to say that is not currently on the form, please let me know.Amount Owed * One Child $85 One Child in 2nd or 8th grade $90 Two or more $105 2 or more with 1 in 2nd or 8th grade $110 Make check, payable to "St. John's PSR", and mail to St. John's, 5567 Gildehaus Road, Villa Ridge, MO 63089Opening Information Note: It looks like JavaScript is disabled in your browser. Some elements of this form may require JavaScript to work properly. If you have trouble submitting the form, try enabling JavaScript momentarily and resubmit. JavaScript settings are usually found in Browser Settings or Browser Developer menu.
