PREP Registration Form 2022-2023

PREP Registration Form: 2022-2023

New Registration for the PREP year
Family Information
Family Last Name*

	First & Last Name	Email	Maiden Name	Cell Phone	Religion
Father
Mother

Home Phone

Area Code Phone Number
Parish Where you are Registered*
Mailing Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
First time registrations - please scan or send a photo of each student's Baptismal Certificate to prep@saintpeterchurch.net.

Students being Registered: = Enter N/A for lines where you do not have any more students.*

	Name	Gender	Birthdate	Name of School	Fall School Year Grade	Fall PREP Year Grade	Baptism Date & Parish	1st Penance Date & Parish	1st Communion Date & Parish
1
2
3
4

Are There Custody/Legal Issues? (If yes, please provide a complete copy of the latest court order.)*

yesno
Name of Person Responsible for Religious Education: (if not a Parent/ Guardian)

Full Name Relationship Phone
Emergency Contact Information: (if we are unable to reach the Parents, whom should we contact? (Must be local)*

Full Name Relationship Phone
I have read the Parent Handbook and agree to the requirements and expectations of the St. Peter Religious Education Program*

yesno
I grant permission for my child's picture to appear on bulletin boards, parish website, newspaper articles, and all social media in relation to events that happen in the parish. (names are never used)*

yesno
Signature (Use mouse to sign.)*

Sign with mouse or touch screen. Clear
Relationship to Student(s)*

Relationship Date

PREP Class Sessions. Choose a session*

Tuesday: 6:15PM - 7:45PMSunday: 9:15AM - 10:45AMHome Study - Parent must attend orientation & abide by contract.
I can help the PREP Program by Volunteering in the following ways:*

CatechistClassroom AideHall MonitorSubstitute (Catechist or Aide)

Medical/Learning Data: Please list your student's name and answer each question. Every block must have an answer. Enter N/A for lines where you do not have any more students.*

	Name	Medical conditions or allergies	Prescribed Medications	Learning Support or *Disability	IEP	**Immunizations Vaccinations up to date	If "no" has an exemption been granted by the current school district
Student1
Student2
Student3
Student4

** Immunizations: Even if your child is exempt from Immunization, he/she may be excluded from PREP during an outbreak of a vaccine preventable disease.

* Disability IDEA: As defined by Individuals with Disabilities Education Act (IDEA), the term "child with a disability" means a child with: an intellectual disability, a hearing impairment (including deafness), a speech or language impairment, a visual impairment (including blindness), a serious emotional disturbance, an orthopedic impairment, autism, traumatic brain injury, another health impairment, a specific learning disability, deaf-blindness, or multiple disabilities, and who, by reason thereof, needs special education and related services.
Please add any other information about your child that should be communicated. Please identify each student your comments are for.
Consent for medical care:

I give permission that, in my absence, my children whose names appear on this registration form, may receive emergency medical care for injuries and all situations that should occur while participating in the Religious Education Program and activities at St. Peter Catholic Church.
Signature (Use mouse to sign.)*

Clear
Relationship to student(s)*

Relationship Date
Upload a photo of your family

Browse Files

Cancelof
Tuition Payment
Payment Method:*

Mail a CheckPayPal Payment link in email. (Preferred)
Should be Empty:

PREP Registration Form: 2022-2023

Family Information

Consent for medical care:

Tuition Payment