Religious Education Registration Online Form

For all NEW students

Please note: All questions with * are required for the full completion of the religious education program.

Parent Information
Are you registered in this parish?
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Name of Father
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Religion of Father
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Name of Mother
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Religion of Mother
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Address
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Primary Phone --
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Secondary Phone --
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Email
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Secondary E-mail
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Emergency Contact Name
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Emergency Contact Relationship
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Emergency Phone Number --
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Your child's mode of transportation.
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Your Child Information
Name of Student
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Birth Date //
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Grade
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Gender
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Sacraments Received
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Has your child been enrolled in Religious Education classes or in a Catholic School before?
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If Yes, in what Parish/School?
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Special Needs: To enable us to serve your child(ren), please indicate any special needs/instructions, diet, allergies, disabilities (e.i. Autism, ADD/ADHD, or physical challengers) as well as any medication(s) your child is taking.
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Parent Involvement
Please check at least one involvement
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Please specify other(s) involvement
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For security purposes, please enter the text that appears in the box below.
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Parent Signature
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