Parish Religious Education Registration Form

Please register your child(ren) for the new 2016-2017 religious education year.

Child 1
Name:
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Address:
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Phone: --
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Entering Grade:
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Baptism Date: //
  •  
1st Penance Date: //
  •  
First Communion Date: //
  •  
Birth Date: //
  •  
Child 2
Name:
  •  
Address:
  •  
Phone: --
  •  
Entering Grade:
  •  
Baptism Date: //
  •  
1st Penance Date: //
  •  
First Communion Date: //
  •  
Birth Date: //
  •  
Child 3
Name:
  •  
Address:
  •  
Phone: --
  •  
Entering Grade:
  •  
Baptism Date: //
  •  
1st Penance Date: //
  •  
First Communion Date: //
  •  
Birth Date: //
  •  
Child 4
Name:
  •  
Address:
  •  
Phone: --
  •  
Entering Grade:
  •  
Baptism Date: //
  •  
1st Penance Date: //
  •  
First Communion Date: //
  •  
Birth Date: //
  •  
Child 5
Name:
  •  
Address:
  •  
Phone: --
  •  
Entering Grade:
  •  
Baptism Date: //
  •  
1st Penance Date: //
  •  
First Communion Date: //
  •  
Birth Date: //
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PARENT'S INFORMATION
Father's Name:
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Address:
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Phone: --
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Religion:
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Mother's Name:
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Address:
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Phone: --
  •  
Religion:
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CHILD'S RESIDENCY
Child resides with:
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If divorced, who has custody?
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Other:
Please indicate if your child has any food allergies or health concerns:
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FEES
FEES: $35 per child or $60 family maximum
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