St John the Evangelist Catholic Church Religious Education Program Registration
Please complete this registration form all the way through, then click submit. Complete a form for each child you enroll.
Student's Information
(Please note: grade should be for 2019- 2020 school year.)
Student’s First Name *
Your answer
Student’s Last Name *
Your answer
Sex (Male/Female) *
Required
Birthday (mm/dd/yyyy) *
MM
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DD
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YYYY
School: *
Your answer
Grade: *
Your answer
Allergies:
Your answer
Special needs:
Your answer
Sacraments your child HAS RECEIVED: *
Required
Sacraments your child NEEDS: *
Required
Mother's Information
Mother’s First Name
Your answer
Mother’s Last Name
Your answer
Mother's Religion:
Your answer
Home phone:
Your answer
Cell phone: *
Your answer
E-mail:
Your answer
Father's Information
Father’s First Name:
Your answer
Father’s Last Name:
Your answer
Father's Religion:
Your answer
Home Phone:
Your answer
*Cell phone:
Your answer
*E-mail:
Your answer
Child lives with:
Home address: *
Your answer
Parent/ Guardian Agreement
Please sign at the bottom of this paragraph.
I understand that I, as the parent or legal guardian of the child listed above, am required to read the parent handbook provided by the Religious Education program at St John the Evangelist Catholic Church. I understand and agree to abide by the guidelines, rules, and regulations set forth in this handbook. I understand that my child(ren) need(s) to observe the basic rules of conduct and adhere to the rules stated in the handbook. I understand that failure to comply with the family handbook could bring about disciplinary actions including, in extreme cases, dismissal of my child from the catechetical program. I understand that I am responsible for sharing the rules, regulations and other important information in this handbook with my child. *
Your answer
Pick up Authorization
We strongly encourage all parents to come into the classroom when dropping off or picking up your children. If your child is in the 4th grade or lower, it is mandatory that you or someone come into the classroom to pick up your child. If a sibling will pick up your child, they MUST be in the 5th grade or higher.
Please list all who have permission to pick up your child other than parents/ guardian:
Your answer
Medical Release
I grant permission for the administration of first aid to my child by the people in charge of St. John the Evangelist, and to make the necessary referrals to qualified physicians for treatment of illness or accidents of a more serious nature. In the case of a medical emergency, I understand that every effort will be made to contact the parents/guardian of the participant. In the event, I cannot be reached I hereby give permission to the physician selected by the adult staff to hospitalize, secure proper treatment for, and to order injection, anesthesia or surgery, if deemed as necessary for my child.
Emergency Contact Name: *
Your answer
Relationship:
Your answer
Home Phone:
Your answer
Cell Phone: *
Your answer
Other:
Your answer
This release form is completed and signed of my own free will with the sole purpose of authorizing medical treatment under emergency circumstances in my absence and only after all efforts have been made to reach me or the emergency contact person(s) listed. Please sign: *
Your answer
Relationship to child:
Your answer
Date:
MM
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DD
/
YYYY
Media Release
I give permission for my child to be photographed during Sunday School classes/ events for the purpose of publicizing the church's activities.
Please check any/all that would apply to your child. *
Required
Parent(s) or Guardian Signature: *
Your answer
Relationship:
Your answer
Date:
MM
/
DD
/
YYYY
*Please make sure the Church has a copy of the Sacrament Certificates that the child has received. Ex: (Baptism certificate.) If your child has NOT been baptized, bring in their Birth Certificate.
Please bring your payment to the office, we will check off your payment for your Sunday School registration, Grades (Kinder- 5th grade). Exact amount please, we do not have change. Tuition is $20 for your first child and $10 for an additional. Please let us know if tuition poses a hardship for you. Students that are in 6th grade and above (Lifeteen & Edge) have a separate registration form. *
Required
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