Holy Redeemer PSR Registration

Holy Redeemer 2022-2023 PSR Registration

Please complete this form in its entirety to successfully register your family for Holy Redeemer's Parish School of Religion.
YOU WILL SUBMIT ONE FORM FOR EACH CHILD. AFTER FIRST SUBMISSION CLICK "REGISTER ANOTHER CHILD" TO ADD ADDITIONAL STUDENTS.
GENERAL INFORMATION
Family Surname(s)
Last Name
What parish are you registered in?

Holy Redeemer
Student(s) live(s) with?

Both Parents Together Mother Father Guardian
Current Mailing Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
PARENT/GUARDIAN INFORMATION

The following information is needed for our database and the student's permanent and Sacramental records.
Name of Mother

First Name Last Name Maiden Name if applicable
Living/Deceased?

Living Deceased
Religion of Mother

Roman Catholic
Marital Status of Mother
Name of Father

First Name Last Name
Living/Deceased?

Living Deceased
Religion of Father

Roman Catholic
Marital Status of Father
Name of Guardian

First Name Last Name
Religion of Guardian

Roman Catholic
Additional Parent Information:
CONTACT INFORMATION

Please submit the parents'/guardian's contact information.
Primary Phone Number and Email will be put into our database to receive PSR updates via text & email.
Primary Phone Number
Whose phone # is this?

Mom Dad Guardian
Primary E-mail
Only fill out secondary contact information if you want PSR updates sent to both people.

If only one parent wants to receive PSR information do not fill in secondary contact information. Rather, use Emergency Contact.
Secondary Phone Number
Whose phone # is this?

Mom Dad Guardian
Secondary E-mail
Please fill out secondary email if you wish to have information sent to both addresses.
Emergency Contact
Emergency Contact 1 (other than parent/guardian listed above)
First and Last Name, Relationship to Student(s)
Emergency Contact 1 Phone Number
Emergency Contact 2 (other than parent/guardian listed above)
First and Last Name, Relationship to Student(s)
Emergency Contact 2 Phone Number
DISMISSAL

Dismissal will be at 7:30pm. Please indicate your dismissal preference. The parking lot is "closed" while children are walking. Cars may NOT move until all children are safely in their car. Those being picked up in the parking lot will be escorted through the exterior gym doors. Dismissal parking is NOT on Joy or Lockwood. Those walking home will exit at the front doors of the school.
Dismissal Preference

I will pick up my child(ren) from the parking lot My child(ren) are allowed to walk home
Additional people allowed to pick up my children other than parents/guardians and emergency contact.
MEDIA AUTHORIZATION

For marketing and publicity purposes, there may be times when the school/parish wishes to use your and/or your child(ren)’s image, name, recording, or academic work in various media for marketing and/or publicity purposes. Our purpose for asking is to mainly use in the bulletin and on the website. As a parent, you may grant or deny authorization.
I grant permission to use my or my child(ren)’s image, name, recording, or academic work in communications that include, but are not limited to, the parish bulletin, school newsletter, parish/school website and social media.

Yes No
BAPTISMAL RECORDS

For NEW students in any grade and those entering, 1st and 2nd grade
Please upload your child's Baptismal Certificate. If you do not have access to it please upload a file with as much information as possible: Church, Date of Baptism with year, Address of Parish of Baptism. If child not baptized, upload a document stating "Child not baptized"

Browse Files

Cancel of
PARENT PARTICIPATION

Parents are the life breath to successful faith formation! We have a number of ways for you to be involved.
Catechist: acts as the faith educator/teacher in the classroom and receives a stipend. Arrive each week by 6:15.

Classroom Aid: makes a weekly commitment and assists the Catechist in the classroom. Arrive each week by 6:15.

Room Parent: periodically helps with classroom necessities.

All volunteer adults must go through Protecting God's Children, have a background check and sign a Code of Ethical Conduct.
Please indicate your preference to help in one of the following areas:

Catechist Classroom Aid Room Parent
STUDENT INFORMATION
Additional children to be added after this form is submitted. Just click "REGISTER ANOTHER CHILD" after each submission.
Student

Please fill out info regarding your child. You will be able to submit additional children after you submit this form.
Child's Full Legal Name

First Name Last Name
Nickname (if applicable)
PSR Grade Level for 2022-2023
Please note, 1st grade level is mandatory prior to 2nd as is 7th grade level is mandatory prior to 8. Transfers must verify attendance from another program.
Child's Birth Date

Month Day Year
Gender
Schools Attended
Please list Elementary and Middle Schools
What would you like us to know about your child to help PSR staff in meeting your child's medical, emotional, spiritual & learning needs.
(e.g. Kathleen is on medication for...has an IEP...has a serious allergy to...experiences difficulty in...) Information will be kept confidential.
TUITION FEE

Tuition for the PSR 2022-2023 year is as follows:

1 Student	$255
2 Students	$470
3+ Students	$675

Please indicate if you'd like to pay by credit card or check. *

Credit Card via Stripe I'd like to set up a payment with Carol, cherber@holyr.org I paid during first submission

If using a Credit Card via Stripe the following fees will be applied. To make your payment select one of the following:

1 Child Tuition $ 255.00

total cost for tuition

2 Children Tuition $ 470.00

total cost for tuition

3+ Children Tuition $ 675.00

total cost for tuition

Total $ 0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Should be Empty:

Holy Redeemer 2022-2023 PSR Registration

YOU WILL SUBMIT ONE FORM FOR EACH CHILD. AFTER FIRST SUBMISSION CLICK "REGISTER ANOTHER CHILD" TO ADD ADDITIONAL STUDENTS.

GENERAL INFORMATION

PARENT/GUARDIAN INFORMATION

CONTACT INFORMATION

Primary Phone Number and Email will be put into our database to receive PSR updates via text & email.

Only fill out secondary contact information if you want PSR updates sent to both people.

Emergency Contact

DISMISSAL

MEDIA AUTHORIZATION

BAPTISMAL RECORDS

PARENT PARTICIPATION

STUDENT INFORMATION

Additional children to be added after this form is submitted. Just click "REGISTER ANOTHER CHILD" after each submission.

Student

TUITION FEE