St. Luke's Parish 2016-2017 PSR Registration
This form is due by September 1, 2016 -- there is a $20 late fee per child.

Please complete this information as completely as possible.
Fees for this year are: 1 child: $60
2 children in the same family: $75
3 or more children in the same family- $90
Sacramental Fee (not included above) is $60 for each child in Grade 2 and/or 7.

September 12, 2016 - PSR Mass at 5:30 pm followed by dinner in McBride Hall. Parents will remain in the hall for a meeting while students go to class from 6:30-7:30 pm. PSR classes following will begin at 6:30pm.

Student's First Name
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Student's Last Name
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Student's Gender
Child's birthdate
MM
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DD
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YYYY
Grade for 2016-2017 PSR
New or returning student?
Home address (including city and zipcode)
Your answer
Please list any known allergies or other information the teachers of this child will need:
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Father's Name
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Father's Religion
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Father's Phone Number
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Father's Email Address
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Mother's Name (including maiden name)
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Mother's Religion
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Mother's Phone Number
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Mother's Email Address
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Does your child have permission to walk home?
If anyone, other than a parent, will pick your child(ren) up from class, please list their name(s) here. (This information is essential for students in grades 1-3 as they are dismissed TO someone.)
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