Religious Education - REGISTRATION
SAINT CHARLES BORROMEO PARISH

“The child grew and became strong, filled with wisdom; and the favor of God was upon him.” (Lk 2:40)
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Child's complete name *
Primary address *
Father's name *
Father's phone # *
Father's email *
Father's English language ability
Clear selection
Mother's name *
Mother's phone # *
Mother's email *
Mother's English language ability *
Date registered in parish
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Family ID / Envelope #
Child's date of birth *
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Please deliver or mail to the parish office (attn: DPE) an original of child's birth certificate.
(unless the certificate was already presented for a previous year's registration)
Child baptized? *
If yes, indicate date and name of church/parish, city, state.
If yes, please deliver or mail to the parish office (attn: DPE) an original of child's Baptism certificate.
(unless the certificate was already presented for a previous year's registration)
Any other sacrament previously received by child? (please indicate which)
Child's grade in school (for 2021-2022 academic year) *
Is Internet access available in your home for educational use (by this September and beyond)? *
Allergies? *
Special needs learning? *
Child lives with *
If necessary, provide the second address.
Do you give permission for your child's name and image to be included for parish-related purposes (for example - publicity in the bulletin, parish website, or local newspaper)? *
Emergency contact name *
Emergency contact phone # *
Today's date *
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DD
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Expect further information about the program from the Director of Parish Evangelization. Thank you and may God bless!
When completed, click "Submit".
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