Couples, please PRINT names individually

Home Address

City

Zip

How many children/youth do you have who are attending a Religious Education Program or Youth Group?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FORM D    Mail this form to the Safe Environment Office with the Attendance Records of KP Presentations to Children/Youth.      Keep a file copy

                   for your parish files.