Religious Education Registration Form

*Student’s Last Name:
*First Name:
*Today’s Date:
*Parent/Guardians Full Names:
Mother’s contact Phone #:
Father’s contact Phone #:
*Emergency Contact name:
*Emergency Person Contact relationship to student:
*Emergency person Contact Phone #
Mother’s Maiden Name:

Mailing Address:

Home address(if different):

*E-Mail will be used to send information for Religious Education purposes:

Both parents Catholic? YESNO



Student’s Name:
Birth Date:
Sex: FemaleMale
Grade:
Rel.Ed.Grade:

Sacraments and Dates

Baptism:
Baptized? YESNO
Catholic? YESNO
If not, in what church was this Sacrament made:

Date (MM/DD/YY):
Please list Church Name:
Address:
City, State, Zip Code:

(If any of your children were baptized outside of Holy Trinity Parish, and you have not already supplied us with a copy of each child’s Baptismal record, you will need to supply a copy for our records.)
Thank you.

Eucharist:
Date (MM/DD/YY):
Please list Church Name:
Address:
City, State, Zip Code:

Penance:
Date (MM/DD/YY):
Please list Church Name:
Address:
City, State, Zip Code:

Confirmation:
Date (MM/DD/YY):
Please list Church Name:
Address:
City, State, Zip Code:

Special Needs:
Medical, learning disabilities and physical disabilities. Please list any and all allergies:




Student’s Name:
Birth Date:
Sex: FemaleMale
Grade:
Rel.Ed.Grade:

Sacraments and Dates

Baptism:
Baptized? YESNO
Catholic? YESNO
If not, in what church was this Sacrament made:

Date (MM/DD/YY):
Please list Church Name:
Address:
City, State, Zip Code:

(If any of your children were baptized outside of Holy Trinity Parish, and you have not already supplied us with a copy of each child’s Baptismal record, you will need to supply a copy for our records.)
Thank you.

Eucharist:
Date (MM/DD/YY):
Please list Church Name:
Address:
City, State, Zip Code:

Penance:
Date (MM/DD/YY):
Please list Church Name:
Address:
City, State, Zip Code:

Confirmation:
Date (MM/DD/YY):
Please list Church Name:
Address:
City, State, Zip Code:

Special Needs:
Medical, learning disabilities and physical disabilities. Please list any and all allergies:




Student’s Name:
Birth Date:
Sex: FemaleMale
Grade:
Rel.Ed.Grade:

Sacraments and Dates

Baptism:
Baptized? YESNO
Catholic? YESNO
If not, in what church was this Sacrament made:

Date (MM/DD/YY):
Please list Church Name:
Address:
City, State, Zip Code:

(If any of your children were baptized outside of Holy Trinity Parish, and you have not already supplied us with a copy of each child’s Baptismal record, you will need to supply a copy for our records.)
Thank you.

Eucharist:
Date (MM/DD/YY):
Please list Church Name:
Address:
City, State, Zip Code:

Penance:
Date (MM/DD/YY):
Please list Church Name:
Address:
City, State, Zip Code:

Confirmation:
Date (MM/DD/YY):
Please list Church Name:
Address:
City, State, Zip Code:

Special Needs:
Medical, learning disabilities and physical disabilities. Please list any and all allergies:




Religious Education Program Fees:

1 Child = $30
2 Children = $45
3+ Children = $55

Tuition amount:
Tuition Paid:

YESNO I have received, read, and understand the goals, guidelines, and procedures outlined in the “Goals and Guidelines” and “Important Safety Information” pages.

YESNO I give my permission for my child to cross the street between Holy Trinity School and Holy Trinity Church, Damien Hall, or the Adoration Chapel with volunteers from the Religious Education Program during class time.

YESNO I give my permission for my child/children’s picture(s) to be taken and for the picture to be displayed on a bulletin board, on the church or school property, or published in family notices home, the parish bulletin, the Anchor Diocesan Newspaper or local newspapers.

YESNO I give my permission for my child/children’s picture(s) to be taken and for the picture to be posted on the Parish website and the Religious Education Facebook page.

YESNO I give my permission for my child/children’s name to be used with their picture (as a caption)

*Signature of parent/guardian

*Required