Religious Education Registration Form
Tuition:

$40.00 per student (up to 2) students
$20 per student (3 or more)
$60.00 per Confirmation student
$50.00 per 1st Communion/Reconciliation student

Email address *
Student's Full Name *
Your answer
The above named will attend Religous Education classes at : (please check one) *
Required
Gender *
Grade in the Fall *
Your answer
Birthdate
MM
/
DD
/
YYYY
Please list any allergies or other medical information that we should know about.
Your answer
If this student has been diagnosed with a learning disability or you suspect that he/she might have a learning disability, please suggest strategies that allow this student to best perform in a classroom setting.
Your answer
Primary Parent/Guardian Information
Mothers Full Name *
Your answer
Mothers Cell/Home/Work Phone Number *
Your answer
Fathers Full Name *
Your answer
Fathers Cell/Home/Work Phone Number *
Your answer
Address, City , Zip Code *
Your answer
I give permission for photographs to be taken of the above student and published in parish records and publications such as the bulletin and the website *
If you have any questions, please contact the parish offices at 419-898-1389 or 419-855-8501
Your answer
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