St. Rose of Lima Church - Religious Education Online Registration

Registration Fees 2020-2021

1 Child $ 135.00
Each additional child $ 50.00
Sacramental fee for: Reconciliation, First Holy Communion and Confirmation - $ 35.00

REGISTRATION IS A TWO-STEP PROCESS. AFTER SUBMITTING THIS FORM, A LINK WILL BE PROVIDED FOR YOU TO PROCEED TO THE ONLINE PAYMENT FORM

Family Information

Are you registered at St. Rose of Lima Church? Yes No

Home Phone

Father's Name

Father's Email

Father's Cell

Father's Religion

Mother's Name

Mother's Maiden Name

Mother's Email

Mother's Cell

Mother's Religion

Family Address

City/State/Zip

Student(s) Information

Third Student

First and Last Name

Date of Birth

Current School Attending

Grade

Child's Grade in Religious Education

Date of Baptism

Church of Baptism

Baptism Certificate Copy Received Pending

Date of Communion

Church of Eucharist

Communion Certificate Copy Received Pending

Years Child has been in the Religious Ed Program

Health Concerns Allergies Health Learning

Please explain concerns

Permission to post photos in media & Website Yes No

Fourth Student

First and Last Name

Date of Birth

Current School Attending

Grade

Child's Grade in Religious Education

Date of Baptism

Church of Baptism

Baptism Certificate Copy Received Pending

Date of Communion

Church of Eucharist

Communion Certificate Copy Received Pending

Years Child has been in the Religious Ed Program

Health Concerns Allergies Health Learning

Please explain concerns

Permission to post photos in media & Website Yes No

Additional Information

Emergency Contact Name

Phone

Relationship to child

Permission to Pick Up Child

I give my permission for the following person to pick up my child(ren).

Name

Cell Phone

Relationship to Child

Volunteer Opportunities

I am interested in teaching Religious Education Yes No

Grade Level

I would like to assist a teacher Yes No

Grade Level

Please check the Security box

Thank you for registering your child(ren) in our Religious Education Program. You must now go to the ONLINE PAYMENT SCREEN to complete the process. CLICK HERE

Religious Education Online Registration

RELIGIOUS EDUCATION

Important Links

SACRAMENTAL PREP

Religious Education Online Registration

RELIGIOUS EDUCATION

Important Links

SACRAMENTAL PREP

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