2019-2020 St. Denis & St. Patrick Faith Formation Registration
Please submit a separate form for each child
Student Last Name
Student First Name
Student Middle Name
Name to send correspondence to
Relationship to Student
Best Number to Reach (Please indicate if cell or home or work)
Additional Contact Number
Additional Contact Person (in case of emergency) - Person's Name
Additional Contact Person (in case of emergency) - Person's Relationship to Student
Additional Contact Person (in case of emergency) - Person's Phone Number
Medical Information - List allergies (medications, food, plants, insects, etc.)
Medical Information - Does student have any physical limitations?
Medical Information - Are there any other special medical conditions that we should be aware of? (Please include any learning disabilities, cognitive disorders)
Picture Consent - Occasionally, we post pictures on our website and other parish locations (bulletins, display boards, slideshows, newsletters, etc.) to inform others about program. Do we have your permission to include your child's picture in any of these media sources?
Program Volunteers - Please check areas you are interested in learning more about.
Catechist (Half Tuition Waived)
Classroom Aide (Half Tuition Waived)
Chaperone for Youth Events
Committee (Meet 5x/yr)
Tuition/Fees - please write check to St. Denis OR St. Patrick
I have already filled out this section for another child.
$65 per child
$195 family maximum
2nd Grade Sacrament Fees - $35
11th Grade Confirmation Fee - $50
Catechist Discount (Divide by 2)
I will mail in check, drop off, or place in collection basket (please make sure it is clearly marked that it is tuition for which student))
I will call 920-757-5090 about payment options &/or tuition assistance.
This is my first time attending Religious Education classes at St. Denis.
No - Thank you, you may submit your form.
Yes - Please email
with child's Sacrament (Baptism, Eucharist) record (Parish, year) or call Parish Office at 920-757-5090 with questions.
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This form was created inside of St. Denis Congregation.