RELIGIOUS EDUCATION REGISTRATION

Student's Name *

First Name

Last Name

Student's Date of Birth *

MM

DD

YYYY

Sacraments to prepare for: *

Check all that apply.

Baptism

Eucharist (First Communion)

Confirmation

Has the student been baptized? *

Yes (Please bring a copy of your child's baptismal certificate to the parish office.)

No

Date of Baptism

MM

DD

YYYY

Do you have access to a computer or tablet to participate in online learning? *

Yes

No

Do you have internet access at home? *

Yes

No

How comfortable are you with using technology like Zoom and Gmail?

Very comfortable

Somewhat comfortable

I don't have much experience using computer software.

Name of Parent/Guardian #1 *

First Name

Last Name

Home Address of Parent/Guardian #1 *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Cell Phone # of Parent/Guardian #1 *

(###)

###

####

Name of Parent/Guardian #2

First Name

Last Name

Home Address of Parent/Guardian #2

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Cell Phone # of Parent/Guardian #2

(###)

###

####

Parents are: *

Single

Married

Separated

Divorced

Mother Deceased

Father Deceased

Other (fill in below)

Student lives with: *

Both Parents

Mother Only

Father Only

Joint Custody

Other (fill in below)

School Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Name

First Name

Last Name

Contact Telephone #

(###)

###

####

What is your preference for scheduling these family days for the upcoming year?

Sunday mornings 10-11am

Saturday afternoons 3-5pm

Other (fill in below)