Religious Education Registration Form
Welcome to Holy Redeemer Religious Education!  Please complete the form below to register.  We meet on Sundays from 10:00-11:30 am.
 * Please fill out separate form for each student.
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Contact us
If you have any questions, please contact Anne Martin, Pastoral Associate, in the Parish Office at 812-424-8344.
Family name *
Primary address *
Father's name *
Father's phone number *
Father's email *
Mother's name *
Mother's phone number *
Mother's email *
Child's name *
Birth Date *
MM
/
DD
/
YYYY
Grade in school *
Baptized? *
Allergies? *
Special learning needs? *
Child lives with *
If necessary, provide the second address
Emergency contact name *
Emergency contact phone *
Payment
$60.00 per child.  Send payment to parish office at Holy Redeemer Church at 918 West Mill Rd., Evansville, IN  47710 or drop your payment in the collection basket using a separate envelope. You may also use PayPal online at www.holyredeemerchurch.org.    Call Anne Martin, Pastoral Associate, for assistance: 812-424-8344.
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