St. Dominic RE Registration 2021/2022
Our year will begin Wednesday, September 8th, with opening Mass.

Please complete the following registration, to help plan for class and volunteer needs. (Multiple children are now able to registered on the same form)

We do request a free-will donation of $25 to help offset the costs of running the program. Please contact Amy Buitenbos (605)530-0361 or stdominicre@gmail.com with any questions.

If you plan on your child receiving initial sacraments at St. Dominic this year, your family must be registered at St. Dominic. If you have any questions about this, please reach out to Amy via phone, email, or stop by the Parish Office.
Email *
Parent's Names *
Address (Street, City, State, Zip) *
Phone *
Child #1 Last Name *
Child #1 First Name *
Child #1 Date of Birth *
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Child #1 Grade in School (ie PK or KP, K, 1, 2, etc) *
Child #2 Last Name
Child #2 First Name
Child #2 Date of Birth
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DD
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YYYY
Child #2 Grade in School (ie PK or KP, K, 1, 2, etc)
Child #3 Last Name
Child #3 First Name
Child #3 Date of Birth
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/
DD
/
YYYY
Child #3 Grade in School (ie PK or KP, K, 1, 2, etc)
Child #4 Last Name
Child #4 First Name
Child #4 Date of Birth
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DD
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YYYY
Child #4Grade in School (ie PK or KP, K, 1, 2, etc)
Child #5 Last Name
Child #5 First Name
Child #5 Date of Birth
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DD
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YYYY
Child #5 Grade in School (ie PK or KP, K, 1, 2, etc)
Do your child(ren) plan to participate in First Reconciliation, First Communion, or Confirmation this year? Please specify child's name and Sacrament below. If your child needs baptism, please contact Amy or Fr. Lawrence.
Emergency Contact Name *
Emergency Contact Phone Number *
Allergies/Special Notes *
How can you help?
A copy of your responses will be emailed to the address you provided.
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