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Online Religious Education Registration

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  St. Patrick Parish
  Religious Education Student Registration 2023-2024
  
  Registration fee: $50
  
  $10 per additional child
  
  Student First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Student Middle Initial Please enter valid data.
  
  Student Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Baptism REQUIRED Please fill out this field. Please enter a date.
  
  Place of Baptism REQUIRED Please fill out this field. Please enter valid data.
  
  School REQUIRED Please fill out this field. Please enter valid data.
  
  Fathers Full Name REQUIRED Please fill out this field. Please enter valid data.
  
  Fathers Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Mothers Maiden Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mothers Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Mailing Address REQUIRED Please fill out this field. Please enter valid data.
  
  Email Address REQUIRED Please fill out this field. Please enter valid data.
  
  Home Phone Number REQUIRED Please fill out this field. Please enter valid data.
  
  Cell Phone Number REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact Name REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact Phone Number REQUIRED Please fill out this field. Please enter valid data.
  
  Any allergies, medications, special health needs this child has that we should know about? REQUIRED Yes No Please fill out this field.
  
  Total previous years of Catholic Religious Education REQUIRED Please fill out this field. Please enter valid data.
  
  Location of Catholic Religious Education REQUIRED Please fill out this field. Please enter valid data.
  
  Who is responsible for this child’s Mass attendance and practice of his/her religion? REQUIRED Please fill out this field. Please enter valid data.
  
  Which Mass time does he/she attend? REQUIRED Please fill out this field. Please enter valid data.
  
  My child will be receiving the Sacraments of Penance/Communion this year (Your child must be in second grade or older and have had at least 1 year prior religious education) REQUIRED Yes No Please fill out this field.
  
  My child will be receiving the Sacrament of Confirmation this year (Your child must be in eighth grade, have made their other Sacraments and have had at least 1 year prior religious education.) REQUIRED Yes No Please fill out this field.
  
  Date of Baptism REQUIRED Please fill out this field. Please enter a date.
  
  Name of Church REQUIRED Please fill out this field. Please enter valid data.
  
  PARISH REGISTRATION NUMBER (on your envelope) YOU MUST BE A REGISTERED PARISHIONER TO ATTEND ERE CLASSES. Registration forms can be picked up at the parish office. REQUIRED Please fill out this field. Please enter valid data.
  
  Is there anything we need to know of to be of better assistance to this child? We are looking for learning needs, special needs, areas of sensitivity, family situation, etc.(We will be respectful of this information.)
  
  Submit
  
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