Religious Education Registration 2023-2024

Registration Fee:

1 Child - $25.00
2 Children - $40.00
3 or more Children - $50.00

Please complete the oline form below - once you submit the form you will be automatically re-directed to the payment screen.
If you prefer, download/print the form then proceed to the payment screen.

FAMILY INFORMATION

Are you a parishioner?

Yes

Father's Name

Mother's Name

Father's Cell

Legal Guardian if different

Home Address

Email Address(es)

Father's Religion

Mother's Religion

Mother's Cell

Guardian's Cell (if necessary)

City/State/Zip

Child Resides with

Both Parents

Mother

Father

Other

If "Other" with whom?

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FIRST STUDENT

First and Last Name

Date of Birth

Grade

Church of Baptism

Church of Eucharist

SECOND STUDENT

First and Last Name

Date of Birth

Grade

Church of Baptism

Church of Eucharist

THIRD STUDENT

First and Last Name

Date of Birth

Grade

Church of Baptism

Church of Eucharist

FOURTH STUDENT

First and Last Name

Date of Birth

Grade

Church of Baptism

Church of Eucharist

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ADDITIONAL INFORMATION

Allergies or other medical conditions (be sure to include child's name)

Emergency Contact Name

Submit

Phone

Relationship to child

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