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Holy Rosary Registration Form (grades k - 4), (3K is closed for 2023-2024)
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* Indicates required question
Child's Full Name
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Age
*
Your answer
Gender
*
Male
Female
What grade level will your child be next year?
*
K
1st Grade
2nd Grade
3rd Grade
4th Grade
Other:
Birth City/State
*
Your answer
Date and Location of Baptism (if baptized)
*
MM
/
DD
/
YYYY
What is your child's experience of Church? (Please comment specifically on the comfort level of your child attending mass and praying in the Church).
Your answer
Is this child Hispanic or Latino?
Yes
No
Clear selection
Primary Language (oral)
Your answer
Primary Language (written)
Your answer
Household information: Father's Full name
Your answer
Father's Address
Your answer
Father's phone (work and cell)
Your answer
Father's employer
Your answer
Father's email
Your answer
Preferred contact method
Email
Phone
Mother's full name
Your answer
Mother's address:
Your answer
Mother's employer & work phone number:
Your answer
Mother's cell phone:
Your answer
Mother's email
Your answer
Preferred contact method:
Email
Phone
The child resides with
Both
Mother
Father
Clear selection
Do you have any concerns about your child's development? (Hearing, Vision, Speech, Behavior, Fine motor skills - coloring, drawing, Gross Motor Skills (running, climbing, jumping).
Your answer
How will you get your child to and from school each day?
*
Your answer
Emergency Contact #1 Name & Relationship to Child
*
Your answer
Emergency Contact #1 Phone Number (cell and work)
*
Your answer
Emergency Contact #1 email
*
Your answer
Emergency Contact #2 Name & Relationship to Child
*
Your answer
Emergency Contact #2 Phone Number (Cell and Work)
*
Your answer
Emergency Contact #2 email
*
Your answer
3K only question: What days will your child need extended care?
Monday
Tuesday
Wednesday
Thursday
Friday
No Extended Care Needed (3k class Monday - Thursday only)
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