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Registration

Event / Program Registration
The maximum number of form submissions has been reached. This form is currently not available.
- Specify Event / Program You Are Registering For: REQUIRED Please fill out this field. Please enter valid data.
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Street Address 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.
- Home Phone REQUIRED Please fill out this field. Please enter a phone number.
- Mobile Phone Number Please enter a phone number.
- Name of Child/Children (if applicable) Please enter valid data.
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Contact for Registration Info
- Beth Scholl
  
  Director of Religious Education
  
  513-941-3661 ext 15
  BethSchollstjosephnorthbend.com
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