2020 Religious Education Registration
Email Address (for all correspondence)*
example@example.com
Number of children registering*
Father's Information
Father's Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Home Phone
Home Phone
Cell Phone
Cell Phone
Work Phone
Work Phone
Email
example@example.com
Marital Status
Select One
Select One
Single
Married
Divorced
Widowed
Are you Catholic?
Yes
No
Education Level Select Highest Completed
Nursery school to 8th grade
Some high school, no diploma
High school graduate, diploma or the equivalent (for example: GED)
Some college credit, no degree
Trade/technical/vocational training
Associate degree
Bachelor’s degree
Master’s degree
Professional degree
Doctorate degre
Back
Next
Father's Sacrament Information
Baptism
Yes
No
Baptism Location
Baptism Date
Year only
Reconciliation
Yes
No
Reconciliation Location
Reconciliation Date
Year only
First Eucharist
Yes
No
First Eucharist Location
First Eucharist Date
Year only
Confirmation
Yes
No
Confirmation Location
Confirmation Date
Year only
Marriage
Yes
No
Marriage Location
Marriage Date
Year only
Back
Next
Mother's Information
Mother's Name
First Name
Last Name
Mother's Maiden Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Home Phone
Home Phone
Cell Phone
Cell Phone
Work Phone
Work Phone
Email
example@example.com
Marital Status
Select one
Select One
Single
Married
Divorced
Widowed
Marital Status
Are you Catholic?
Yes
No
Education Level Select Highest Completed
Nursery school to 8th grade
Some high school, no diploma
High school graduate, diploma or the equivalent (for example: GED)
Some college credit, no degree
Trade/technical/vocational training
Associate degree
Bachelor’s degree
Master’s degree
Professional degree
Doctorate degre
Back
Next
Mother's Sacrament Information
Baptism
Yes
No
Baptism Location
Baptism Date
Year only
Reconciliation
Yes
No
Reconciliation Location
Reconciliation Date
Year only
First Eucharist
Yes
No
First Eucharist Location
First Eucharist Date
Year only
Confirmation
Yes
No
Confirmation Location
Confirmation Date
Year only
Marriage
Yes
No
Marriage Location
Marriage Date
Year only
Back
Next
Student One Information
Student's Name
Gender
Male
Female
Catholic?
Yes
No
Grade In School
Birth Date
-
Month
-
Day
Year
Date Picker Icon
Sacrament Information
Baptism
Yes
No
Baptism Date
Year only
Baptism - Church Name
Baptism - Location
First time registration for each child: Please provide a Baptismal Certificate if your child was not baptized at a St. Bernard & St. Stanislaus Parish.
Browse Files
Cancel
of
Reconciliation
Yes
No
Reconciliation Date
Year only
Reconciliation - Church Name
Reconciliation - Location
First Eucharist
Yes
No
First Eucharist Date
Year only
First Eucharist - Church Name
First Eucharist - Location
Confirmation
Yes
No
Confirmation Date
Year only
Confirmation - Church Name
Confirmation - Location
Back
Next
Medical Information - Student One
Does your son/ daughter have any medical problems, allergies or physical limitations that we should know about ?
Yes
No
If yes, please explain
Doctor's Name
Doctor's Phone Number
Doctor's Phone Number
Hospital Preference
In case of a medical emergency, I give Bernard of Clairvaux and St. Stanislaus Kostka authorization to take my child for emergency medical care.
Yes
No
Add another child?
*
Yes
No
Back
Next
Student Two Information
Student's Name
Gender
Male
Female
Catholic?
Yes
No
Grade In School
Birth Date
-
Month
-
Day
Year
Date Picker Icon
Sacrament Information
Baptism
Yes
No
Baptism Date
Year only
Baptism - Church Name
Baptism - Location
First time registration for each child: Please provide a Baptismal Certificate if your child was not baptized at a St. Bernard & St. Stanislaus Parish.
Browse Files
Cancel
of
Reconciliation
Yes
No
Reconciliation Date
Year only
Reconciliation - Church Name
Reconciliation - Location
First Eucharist
Yes
No
First Eucharist Date
Year only
First Eucharist - Church Name
First Eucharist - Location
Confirmation
Yes
No
Confirmation Date
Year only
Confirmation - Church Name
Confirmation - Location
Back
Next
Medical Information - Student Two
Does your son/ daughter have any medical problems, allergies or physical limitations that we should know about ?
Yes
No
If yes, please explain
Doctor's Name
Doctor's Phone Number
Doctor's Phone Number
Hospital Preference
In case of a medical emergency, I give Bernard of Clairvaux and St. Stanislaus Kostka authorization to take my child for emergency medical care.
Yes
No
Add another child?
*
Yes
No
Back
Next
Student Three Information
Student's Name
Gender
Male
Female
Catholic?
Yes
No
Grade In School
Birth Date
-
Month
-
Day
Year
Date Picker Icon
Sacrament Information
Baptism
Yes
No
Baptism Date
Year only
Baptism - Church Name
Baptism - Location
First time registration for each child: Please provide a Baptismal Certificate if your child was not baptized at a St. Bernard & St. Stanislaus Parish.
Browse Files
Cancel
of
Reconciliation
Yes
No
Reconciliation Date
Year only
Reconciliation - Church Name
Reconciliation - Location
First Eucharist
Yes
No
First Eucharist Date
Year only
First Eucharist - Church Name
First Eucharist - Location
Confirmation
Yes
No
Confirmation Date
Year only
Confirmation - Church Name
Confirmation - Location
Back
Next
Medical Information - Student Three
Does your son/ daughter have any medical problems, allergies or physical limitations that we should know about ?
Yes
No
If yes, please explain
Doctor's Name
Doctor's Phone Number
Doctor's Phone Number
Hospital Preference
In case of a medical emergency, I give Bernard of Clairvaux and St. Stanislaus Kostka authorization to take my child for emergency medical care.
Yes
No
Add another child?
*
Yes
No
Back
Next
Student Four Information
Student's Name
Gender
Male
Female
Catholic?
Yes
No
Grade In School
Birth Date
-
Month
-
Day
Year
Date Picker Icon
Sacrament Information
Baptism
Yes
No
Baptism Date
Year only
Baptism - Church Name
Baptism - Location
First time registration for each child: Please provide a Baptismal Certificate if your child was not baptized at a St. Bernard & St. Stanislaus Parish.
Browse Files
Cancel
of
Reconciliation
Yes
No
Reconciliation Date
Year only
Reconciliation - Church Name
Reconciliation - Location
First Eucharist
Yes
No
First Eucharist Date
Year only
First Eucharist - Church Name
First Eucharist - Location
Confirmation
Yes
No
Confirmation Date
Year only
Confirmation - Church Name
Confirmation - Location
Back
Next
Medical Information - Student Four
Does your son/ daughter have any medical problems, allergies or physical limitations that we should know about ?
Yes
No
If yes, please explain
Doctor's Name
Doctor's Phone Number
Doctor's Phone Number
Hospital Preference
In case of a medical emergency, I give Bernard of Clairvaux and St. Stanislaus Kostka authorization to take my child for emergency medical care.
Yes
No
Add another child?
*
Yes
No
Back
Next
Student Five Information
Student's Name
Gender
Male
Female
Catholic?
Yes
No
Grade In School
Birth Date
-
Month
-
Day
Year
Date Picker Icon
Sacrament Information
Baptism
Yes
No
Baptism Date
Year only
Baptism - Church Name
Baptism - Location
First time registration for each child: Please provide a Baptismal Certificate if your child was not baptized at a St. Bernard & St. Stanislaus Parish.
Browse Files
Cancel
of
Reconciliation
Yes
No
Reconciliation Date
Year only
Reconciliation - Church Name
Reconciliation - Location
First Eucharist
Yes
No
First Eucharist Date
Year only
First Eucharist - Church Name
First Eucharist - Location
Confirmation
Yes
No
Confirmation Date
Year only
Confirmation - Church Name
Confirmation - Location
Back
Next
Medical Information - Student Five
Does your son/ daughter have any medical problems, allergies or physical limitations that we should know about ?
Yes
No
If yes, please explain
Doctor's Name
Doctor's Phone Number
Doctor's Phone Number
Hospital Preference
In case of a medical emergency, I give Bernard of Clairvaux and St. Stanislaus Kostka authorization to take my child for emergency medical care.
Yes
No
Add another child?
*
Yes
No
Back
Next
Student Six Information
Student's Name
Gender
Male
Female
Catholic?
Yes
No
Grade In School
Birth Date
-
Month
-
Day
Year
Date Picker Icon
Sacrament Information
Baptism
Yes
No
Baptism Date
Year only
Baptism - Church Name
Baptism - Location
First time registration for each child: Please provide a Baptismal Certificate if your child was not baptized at a St. Bernard & St. Stanislaus Parish.
Browse Files
Cancel
of
Reconciliation
Yes
No
Reconciliation Date
Year only
Reconciliation - Church Name
Reconciliation - Location
First Eucharist
Yes
No
First Eucharist Date
Year only
First Eucharist - Church Name
First Eucharist - Location
Confirmation
Yes
No
Confirmation Date
Year only
Confirmation - Church Name
Confirmation - Location
Back
Next
Medical Information - Student Six
Does your son/ daughter have any medical problems, allergies or physical limitations that we should know about ?
Yes
No
If yes, please explain
Doctor's Name
Doctor's Phone Number
Doctor's Phone Number
Hospital Preference
In case of a medical emergency, I give Bernard of Clairvaux and St. Stanislaus Kostka authorization to take my child for emergency medical care.
Yes
No
Add another child?
*
Yes
No
Back
Next
Student Seven Information
Student's Name
Gender
Male
Female
Catholic?
Yes
No
Grade In School
Birth Date
-
Month
-
Day
Year
Date Picker Icon
Sacrament Information
Baptism
Yes
No
Baptism Date
Year only
Baptism - Church Name
Baptism - Location
First time registration for each child: Please provide a Baptismal Certificate if your child was not baptized at a St. Bernard & St. Stanislaus Parish.
Browse Files
Cancel
of
Reconciliation
Yes
No
Reconciliation Date
Year only
Reconciliation - Church Name
Reconciliation - Location
First Eucharist
Yes
No
First Eucharist Date
Year only
First Eucharist - Church Name
First Eucharist - Location
Confirmation
Yes
No
Confirmation Date
Year only
Confirmation - Church Name
Confirmation - Location
Back
Next
Medical Information - Student Seven
Does your son/ daughter have any medical problems, allergies or physical limitations that we should know about ?
Yes
No
If yes, please explain
Doctor's Name
Doctor's Phone Number
Doctor's Phone Number
Hospital Preference
In case of a medical emergency, I give Bernard of Clairvaux and St. Stanislaus Kostka authorization to take my child for emergency medical care.
Yes
No
Add another child?
Yes
No
Back
Next
Student Eight Information
Student's Name
Gender
Male
Female
Catholic?
Yes
No
Grade In School
Birth Date
-
Month
-
Day
Year
Date Picker Icon
Sacrament Information
Baptism
Yes
No
Baptism Date
Year only
Baptism - Church Name
Baptism - Location
First time registration for each child: Please provide a Baptismal Certificate if your child was not baptized at a St. Bernard & St. Stanislaus Parish.
Browse Files
Cancel
of
Reconciliation
Yes
No
Reconciliation Date
Year only
Reconciliation - Church Name
Reconciliation - Location
First Eucharist
Yes
No
First Eucharist Date
Year only
First Eucharist - Church Name
First Eucharist - Location
Confirmation
Yes
No
Confirmation Date
Year only
Confirmation - Church Name
Confirmation - Location
Back
Next
Medical Information - Student Eight
Does your son/ daughter have any medical problems, allergies or physical limitations that we should know about ?
Yes
No
If yes, please explain
Doctor's Name
Doctor's Phone Number
Doctor's Phone Number
Hospital Preference
In case of a medical emergency, I give Bernard of Clairvaux and St. Stanislaus Kostka authorization to take my child for emergency medical care.
Yes
No
Back
Next
Emergency Contact Information
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Relationship to child
Home Phone Number
Home Phone Number
Cell Phone Number
Cell Phone Number
Submit
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