Saint Catherine of Siena Catholic Church Religious Education Registration Form School Year: 2020-2021
Office of Religious Education
1020 Springvale Road
Great Falls, Virginia 22066
(703) 759-3530
Email address *
Child Full Name (Last name first) *
Gender *
Sacraments received *
Date Registered *
Class Time Preference *
Student School Grade *
Date of Birth *
Allergies (yes or No). If yes, please explain *
Family Registered Parishioner *
Family Parish ID#
Name of the parish? (if not a parishioner at St. Catherine of Siena) *
Mailing Address (City, State and Zip) *
Primary phone to contact *
Father's last and first name *
Father's email address *
Father's phone *
Father's religion *
Mother's last name and first name *
Mother's email address *
Mother's phone *
Mother's religion *
Emergency Contact Information (If parents cannot be contacted) 1. First and Last Name 2. Phone (Home/ work/cell) 3. Relationship to child *
Siblings in Religious Formation: List Full Name / Grade / Gender / Date of Birth / Alergies (Y/N). *
Parent's signature and date (Note: Tuition payment either by mail or drop off the RE Office. Please make checks payable to: St. Catherine of Siena Catholic Church). *
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