St. Mary St. Catherine Religious Education 2018-2019 Registration
Name
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Grade *
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Class day and time preference *
Date of Birth *
MM
/
DD
/
YYYY
Home Address *
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School Attending *
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Mother's (Guardian's) Name *
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Mother's cell phone *
Your answer
Mother's Religious Denomination *
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Mother's email address *
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Father's (Guardian's) Name *
Your answer
Father's cell phone *
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Father's Religious Denomination *
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Father's email address *
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Sacraments Received - please list date, parish, and city/town
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Baptism *
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First Communion *
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Any special needs or accommodations?
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Can your child receive snacks in class?
Does your child have allergies? If yes, please describe
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My child can walk home from class alone
Emergency Contact Name and Telephone *
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