Religious Education Registration

Family Last Name (Required)

New Family Enrollment

Renew Family Enrollment

Child/Children's Address (Required)

Father's Information

Full Name (Required)

Occupation

Catholic

Yes

Street address

City

Practicing

Yes

State

If non-Catholic, other Faith

Zip

Use This Cell Phone / Email as Family's Primary Contact

Cell Phone

Work Phone

Mother's Information

Full Name (Required)

Maiden Name

Street Address

City

State

Zip

Cell Phone

Work Phone

Occupation

Catholic

Yes

Practicing

Yes

If non-Catholic, other Faith

Use This Cell Phone / Email as Family's Primary Contact

TUITION:
$ 195.00 FOR ONE CHILD
$ 220.00 FOR TWO CHILDREN
$ 240.00 FOR THREE OR MORE CHILDREN

PLEASE NOTE: PAYMENT MUST BE RECEIVED TO COMPLETE REGISTRATION

Family Registered Members of Holy Eucharist

Yes

(If no, Parish currently registered)

Flocknote

Yes, I would like to receive Flocknote email notifications

No thanks

2022 – 2023 RELIGIOUS EDUCATION CLASS SCHEDULE OPTIONS

Tuesdays: 5:00 – 6:00 PM (grades 1 – 4)
Wednesdays: 5:00 – 6:00 PM (grades 1 – 4)

Tuesdays: 6:30 – 8:00 PM (grades 5 – 8)
Wednesdays: 6:30 -8:00 PM (grades 5 – 8)

IN CASE OF ACCIDENT OR SERIOUS ILLNESS, IF NEITHER PARENT CAN BE REACHED, YOU HAVE MY PERMISSION TO CONTACT ANY ONE OF THE FOLLOWING INDIVIDUALS AND CALL 911 IF NECESSARY:

Emergency Contact (Required)

Relationship (Required)

Telephone (Required)

PLEASE COMPLETE FULLY FOR EACH CHILD YOU ARE REGISTERING:

Child #1

Returning Student (attended 2021-22 or Summer Program)

NEW STUDENT (did not attend 2021-22 / Summer)

Session Choice

Tuesdays: 5:00 - 6:00 PM (grades 1 - 4)

Wednesdays: 5:00 - 6:00 PM (grades 1 - 4)

Tuesdays: 6:30 - 8:00 PM (grades 5 - 8)

Wednesdays: 6:30 - 8:00 PM (grades 5 - 8)

Full Baptismal Name (Required)

City & State of Birth (Required)

Full Date of Birth (Required)

School (Sept 2022) (Required)

Grade (Sept 2022) (Required)

Cognitive/Learning Disabilities (Required)

Allergies (Required)

Medical Concerns / Medications (Required)

Additional Comments

IF NEW: Please provide Sacramental and Previous Religious Education History/Documents (See below also)

Baptism Date (Required)

Church Name/Address (Required)

Penance Date (Required)

Church Name/Address (Required)

Eucharist Date (Required)

Church Name/Address (Required)

Previous Religious Education Parish/Address (Required)

Grade(s) (Required)

Previous Catholic School/Address (Required)

Grade(s) (Required)

Child #2

Returning Student (attended 2021-22 or Summer Program)

NEW STUDENT (did not attend 2021-22 / Summer)

Session Choice

Tuesdays: 5:00 - 6:00 PM (grades 1 - 4)

Wednesdays: 5:00 - 6:00 PM (grades 1 - 4)

Tuesdays: 6:30 - 8:00 PM (grades 5 - 8)

Wednesdays: 6:30 -8:00 PM (grades 5 - 8)

Full Baptismal Name

City & State of Birth

Full Date of Birth

School (Sept 2022)

Grade (Sept 2022)

Cognitive/Learning Disabilities

Allergies

Medical Concerns / Medications

Additional Comments

IF NEW: Please provide Sacramental and Previous Religious Education History/Documents (See below also)

Baptism Date

Church Name/Address

Penance Date

Church Name/Address

Eucharist Date

Church Name/Address

Previous Religious Education Parish/Address

Grade(s)

Previous Catholic School/Address

Grade(s)

Child #3

Returning Student

Returning Student (attended 2021-22 or Summer Program)

NEW STUDENT (did not attend 2021-22 / Summer)

Session Choice

Tuesdays: 5:00 - 6:00 PM (grades 1 - 4)

Wednesdays: 5:00 - 6:00 PM (grades 1 - 4)

Tuesdays: 6:30 - 8:00 PM (grades 5 - 8)

Wednesdays: 6:30 -8:00 PM (grades 5 - 8)

Full Baptismal Name

City & State of Birth

Full Date of Birth

School (Sept 2022)

Grade (Sept 2022)

Cognitive/Learning Disabilities

Allergies

Medical Concerns / Medications

Additional Comments

IF NEW: Please provide Sacramental and Previous Religious Education History/Documents (See below also)

Baptism Date

Church Name/Address

Penance Date

Church Name/Address

Eucharist Date

Church Name/Address

Previous Religious Education Parish/Address

Grade(s)

Previous Catholic School/Address

Grade(s)

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