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St. Augustine PSR Family Registration Form: Personal Information

This document is a 2-page family registration form for St. Augustine Parish School of Religion. It requests personal information about parents/guardians and children, including names, contact details, religion, and parish registered at. Medical information and emergency contacts for the children are also collected. The second page provides space to list each child's name, birthdate, current school, previous religious education grades, and sacraments received. It also outlines the registration fees for the school of religion.

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St Augustine Church
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33 views

St. Augustine PSR Family Registration Form: Personal Information

This document is a 2-page family registration form for St. Augustine Parish School of Religion. It requests personal information about parents/guardians and children, including names, contact details, religion, and parish registered at. Medical information and emergency contacts for the children are also collected. The second page provides space to list each child's name, birthdate, current school, previous religious education grades, and sacraments received. It also outlines the registration fees for the school of religion.

Uploaded by

St Augustine Church
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 3

St.

Augustine PSR
Family Registration Form
PAGE 1 of 2

Todays Date: __/__/____

See Payment Sheet for Fee

Paid ____ Check # _________

Personal Information
3

Father:

Last name __________________________ First name _______________________

2 Mother:
Last name _______________________ First name __________________ Maiden name _____________

Marital status: Married

Divorced

Single Parent

3 Guardian: (If Not Applicable, please leave blank)


Last name _________________ First name _______________ Relationship to Child: ______________
Who is authorized to pick up the child(ren) and what is their relationship to the child(ren)?

Parent/Guardian Religion: __________________

Parish Registered at: ______________________

Children and Grades:_________________________________________________________________________


___________________________________________________________________________________________

Contact Information
[of primary caregiver(s)]

Mailing Address Street: ______________________ City/state:________________

Zip:____________

Addressed to: __________________________


Phone#1: Cell ___________________ Home __________________ Whose ____________________
Phone#2: Cell ___________________ Home __________________ Whose ____________________

Email 1: ______________________________

Email 2: _______________________________

Child Information
PAGE 2 of 2

Last name: ____________________________

First name: ___________________________

Middle name: __________________________

Current School: __________________________

Gender: M / F

Birth date: ___/___/_____

Grade: _____

Last Completed Grade of Religious Education (please circle):


0

Will the child have irregular attendance due to custodial issues? ______________________
Explain:______________________________________________________________________

Sacraments Received:
First Communion

Baptism

/ Where ________________

/ Where ____________________

Confirmation

Emergency Contact (When parent cannot be reached)


Name: _______________________________________
Relationship to Child: __________________________

Number: ___________________________

Medical Information
Primary Caregiver Name and Number:_____________________________________________________
Health Conditions: ______________________________________________________________________
Medications: ___________________________________________________________________________
Allergies: ______________________________________________________________________________
Preferred Hospital:______________________________________________________________________
Additional Comments: __________________________________________________________________
______________________________________________________________________________________

St. Augustine Parish School of Religion Registration Fee:


Parishioners of St. Augustine and Immaculate Conception:

All Other Parishes:

If paid by August 14:


1 Child

$90.00

1 Child

$95.00

2 or more

$110.00

2 or more

$115.00

If paid after August 14:


1 Child

$95.00

1 Child

$100.00

2 or more

$115.00

2 or more

$120.00

If you are in need of a scholarship, please let me know and we can work something out.

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