Religious Education

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Today's Date REQUIRED Please fill out this field. Please enter a date.
Father's Information
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Work/Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- Catholic? yes no
Mother's Information
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Work/Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- Catholic? yes no
Custodial Parent (if different from above) Please enter valid data.
Home Address REQUIRED Please fill out this field. 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.
Home Phone REQUIRED Please fill out this field. Please enter a phone number.
Email REQUIRED Please fill out this field. Please enter an email address.
Emergency Contact REQUIRED Please fill out this field. Please enter valid data.
Emergency Contact Phone Number REQUIRED Please fill out this field. Please enter valid data.
Is your family registered at a church? REQUIRED Yes No Please fill out this field.
If yes, at which church is your family registered? Please enter valid data.
Note: If any of your children were baptized outside of this community and you have not already supplied us with a copy of each child's baptismal record, you will need to submit a copy for our files.
- How many children are you registering? REQUIRED Please fill out this field.
- Child 1
  - First Name Please enter valid data.
    
    Last Name Please enter valid data.
  - Date of Birth Please enter a date.
  - Age Please enter valid data.
  - Gender REQUIRED Male Female Please fill out this field.
  - School Please enter valid data.
  - Grade Please enter valid data.
  - Baptized Catholic? Yes No
  - First Reconciliation received? Yes No
  - First Eucharist received? Yes No
  - Special needs (please list any medical, physical, learning disabilities, and/or allergies)
  - I wish to enroll my child in: REQUIRED Sunday RE Class: Pre-K (age 4 by August 1) 11:00-12:00 Mass Sunday RE Class: Kindergarten (age 5 by August 1) 11:00-12:00 Mass Wednesday RE Class: 1st Grade - 8th Grade 6:00-7:15 PM Monday Confirmation Class: High School Students 7:00-8:45 PM Please fill out this field.
  - Can we take your child's photo? Yes No
- Child 2
  - First Name Please enter valid data.
    
    Last Name Please enter valid data.
  - Date of Birth Please enter a date.
  - Age Please enter valid data.
  - Gender REQUIRED Male Female Please fill out this field.
  - School Please enter valid data.
  - Grade Please enter valid data.
  - Baptized Catholic? Yes No
  - First Reconciliation received? Yes No
  - First Eucharist received? Yes No
  - Special needs (please list any medical, physical, learning disabilities, and/or allergies)
  - I wish to enroll my child in: REQUIRED Sunday RE Class: Pre-K (age 4 by August 1) 11:00-12:00 Mass Sunday RE Class: Kindergarten (age 5 by August 1) 11:00-12:00 Mass Wednesday RE Class: 1st Grade - 8th Grade 6:00-7:15 PM Monday Confirmation Class: High School Students 7:00-8:45 PM Please fill out this field.
  - Can we take your child's photo? Yes No
- Child 3
  - First Name Please enter valid data.
    
    Last Name Please enter valid data.
  - Date of Birth Please enter a date.
  - Age Please enter valid data.
  - Gender REQUIRED Male Female Please fill out this field.
  - School Please enter valid data.
  - Grade Please enter valid data.
  - Baptized Catholic? Yes No
  - First Reconciliation received? Yes No
  - First Eucharist received? Yes No
  - Special needs (please list any medical, physical, learning disabilities, and/or allergies)
  - I wish to enroll my child in: REQUIRED Sunday RE Class: Pre-K (age 4 by August 1) 11:00-12:00 Mass Sunday RE Class: Kindergarten (age 5 by August 1) 11:00-12:00 Mass Wednesday RE Class: 1st Grade - 8th Grade 6:00-7:15 PM Monday Confirmation Class: High School Students 7:00-8:45 PM Please fill out this field.
  - Can we take your child's photo? Yes No
- Child 4
  - First Name Please enter valid data.
    
    Last Name Please enter valid data.
  - Date of Birth Please enter a date.
  - Age Please enter valid data.
  - Gender REQUIRED Male Female Please fill out this field.
  - School Please enter valid data.
  - Grade Please enter valid data.
  - Baptized Catholic? Yes No
  - First Reconciliation received? Yes No
  - First Eucharist received? Yes No
  - Special needs (please list any medical, physical, learning disabilities, and/or allergies)
  - I wish to enroll my child in: REQUIRED Sunday RE Class: Pre-K (age 4 by August 1) 11:00-12:00 Mass Sunday RE Class: Kindergarten (age 5 by August 1) 11:00-12:00 Mass Wednesday RE Class: 1st Grade - 8th Grade 6:00-7:15 PM Monday Confirmation Class: High School Students 7:00-8:45 PM Please fill out this field.
  - Can we take your child's photo? Yes No

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