Religious Education Registration
2018-2019 (fill out one for each student)
Email address *
Click the bubble next to when your student will be attending Religious Education *
Student Full Name (Please Include Middle Name) *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Place of Birth *
Your answer
Grade in School *
Mother's Full Name (Including Maiden & Middle)
Your answer
Father's Full Name (Including Middle Name)
Your answer
Address (Including city) *
Your answer
Telephone - Home
Your answer
Telephone - Cell
Your answer
Email Address *
Your answer
Are you willing to help out with snacks or special events?
Medical Concerns/Allergies
Your answer
Emergency Contact person(s) (please include telephone number) *
Your answer
Baptism Date, Location, & Church
Your answer
1st Eucharist Date, Location, & Church
Your answer
Confirmation Date, Location, & Church
Your answer
Names & Ages of other children in the home
Your answer
Is your family registered in the Parish? *
Anything else we need to know
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google.