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00 Make checks payable to ST. Joseph the Worker After School Program. For Office Use Date Check Amt. Name Relationship Phone We reserve the right to decline or cancel participation in this program due to disciplinary concerns nonpayment of fees or if children are not picked up by 6 00 pm. Parent s Signature Date Please return this completed form with the non-refundable fee of 65. ST. JOSEPH THE WORKER AFTER SCHOOL PROGRAM Registration Form Please Print Student s Name Grade Age Date of Birth...
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