Parish Religious Education Program

Child's Name*

First Middle Last

My child's PREFERRED name (nickname)*

Child's Date of Birth*

MM

DD

YYYY

2018-2019 School Attending:*

2018-2019 Grade*

Home Address:*

Street Address Address Line 2 City State Zip

Sacramental History

Has your child been BAPTIZED?*

Yes
No

Date of BAPTISM*

If your child has not been BAPTIZED, put N/A

Church of Baptism*

Name of Church City State / Province / Region

Indicate name of Church, City & State. If your child has not been BAPTIZED, put N/A

Has your child received FIRST PENANCE?*

Yes
No

Date of FIRST PENANCE*

If your child has not received FIRST PENANCE, put N/A

Church of First Penance*

Name of Church City State / Province / Region

Indicate name of Church, City & State. If your child has not received FIRST PENANCE, put N/A

Has your child received FIRST HOLY COMMUNION?*

Yes
No

Date of FIRST HOLY COMMUNION*

If your child has not received FIRST HOLY COMMUNION, put N/A

Church of First Communion*

Name of Church City State / Province / Region

Indicate name of Church, City & State. If your child has not received FIRST COMMUNION, put N/A

Upload Baptismal Certificate

NOTE: If your child was NOT baptized at St. Louis Church and is entering 2nd or 8th grade, ATTACH A COPY OF THE BAPTISMAL CERTIFICATE TO THIS REGISTRATION. DO NOT SUBMIT REGISTRATION UNTIL BAPTISMAL DOCUMENTATION IS ATTACHED.

Parental Information

Father:

Name:*

First Last

Religion:*

Mobile Phone:*

Home Phone:*

Other Phone:

Address (if different from above)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email Address:*

Member of St. Louis Parish:*

Yes
No

Mother

Name:*

First Last

Religion:*

Mobile Phone:*

Home Phone:*

Other Phone:

Address (if different from above)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email Address:*

Member of St. Louis Parish:*

Yes
No

Media Release

For purposes of public relations, and for use on our website and social media forums, photographs are occasionally taken at our classes and events. To avoid any violation of privacy, minors attending the event(s) need permission from parents/guardians to have photographs taken of them. Photographs may be taken by St. Louis Catholic Church and may be used by St. Louis Catholic Church following the event(s). Please choose below: I DO GIVE / DO NOT GIVE permission for St. Louis Catholic Church to use these pictures for public relations, on the St. Louis Catholic Church website and social media forums.

Untitled*

I do give permission
I do NOT give permission

Emergency Information

Please list a trusted individual who may be contacted in the case of an emergency on SUNDAY MORNINGS during class time. This individual will be contacted only in the case where a parent cannot be reached.

Name:*

First Last

Mobile Phone:*

Home Phone:*

Other Phone:

Health Concerns*

Please list any student health concerns of which staff should be made aware (such as acute allergies to food or medication):

Preferred Hospital (based on insurance)*

St. Louis Catholic Church

Faith Formation

Ministries

Resources

PRE Registration

Sacramental History

Parental Information

Father:

Mother

Media Release

Emergency Information