Religious Education Online Registration2021 – 2022

Fee: $50 per family

Child's Name*
First Last
Date of Birth*
School*
Grade (2021-22)*
Registration Type*
- New Registration
- Returning Registration
If this is a new registration, please attach a copy of the baptism certificate

I give my child permission to participate in the all religious education activities and functions
Consent*
I agree to the consent text below
I give my child permission to participate in all religious education activities and functions.
Date*
MM slash DD slash YYYY
Family Information
Father's Name*
First Last
Father's Religion*
Father's Occupation*
Father's Cell Phone*
Father's Email*
Mother's Name*
First Last (Maiden)
Mother's Religion*
Mother's Occupation*
Mother's Cell Phone*
Mother's Email*
Student Address*
Street Address Address Line 2 City State ZIP Code
Home Phone*
Does your child have an IEP?*
- Yes
- No
Does your child need special support in classroom settings?*
- Yes
- No
What kind of support?*
Does your child have any allergies?*
- Yes
- No
What are they?*
Where was your child born?*

Include Town and State
Sacraments
Date of Baptism*
Church & Address of Baptism*
Date of First Penance*
Church & Address of First Penance*
Date of First Communion*
Church & Address of First Communion*
CAPTCHA

Family Information