Religious Education Registration Form

Phone

This field is for validation purposes and should be left unchanged.

Parent/Guardian Full Name(Required)

First Last

Parent/Guardian Phone(Required)

Parent/Guardian Email(Required)

(** We use email to communicate important information relevant to your child’s faith formation class/parish life)

Parent/Guardian Secondary Contact Phone(Required)

Parent/Guardian Address(Required)

Street Address Address Line 2 City State ZIP Code

Child's Name(Required)

First Last

Grade Entering this Fall(Required)

Allergies/health concerns we should be aware of:

Date of Birth(Required)

Date of Baptism

Sacrament Year (Prk-8th Select N/A)(Required)

Confirmation year 1 (9th Grade)

Confirmation Year 2 (10th Grade)

First Communion/Reconciliation (2nd/3rd Grade)

N/A

Upload a copy of your Childs Baptismal Certificate

Max. file size: 200 MB.

(Required for First Communion & 7th- 10th graders if you did not provide one last year. If you do not have one at this time, we can collect it from you at a later date)

Photos(Required)

Yes

I allow pictures of my child to be used in Saint Therese publications (bulletin and/or website) for the purpose of program promotion and education.

2nd Child's Name

First Last

Grade Entering this Fall

Allergies/health concerns we should be aware of:

Date of Birth

Date of Baptism

Sacrament Year (Prk-8th Select N/A)

Confirmation year 1 (9th Grade)

Confirmation Year 2 (10th Grade)

First Communion/Reconciliation (2nd/3rd Grade)

N/A

Upload a copy of your Childs Baptismal Certificate

Max. file size: 200 MB.

(Required for First Communion & 7th- 10th graders if you did not provide one last year. If you do not have one at this time, we can collect it from you at a later date)

Photos

Yes

I allow pictures of my child to be used in Saint Therese publications (bulletin and/or website) for the purpose of program promotion and education.