2024-2025 Religious Education Registration

Mother's Name*

First NameLast Name

Cell Phone*

Please enter a valid phone number.

Father's Name*

First NameLast Name

Cell Phone*

Please enter a valid phone number.

Preferred Email Address *

example@example.com

2nd Email Address (optional)

example@example.com

Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

How many students are you enrolling into Religious Ed?*

1234

Student Name*

First NameLast Name

Grade they're entering in September 2024 (K-5 only)*

Student Date of Birth*

ex: 01/01/10

List any learning, behavioral, or medical conditions:

Sacraments your child has received:*

BaptismFirst ReconciliationFirst Communion

Student Name #2*

First NameLast Name

Grade they're entering in September 2024 (K-5 only)*

Student Date of Birth*

ex: 01/01/10

List any learning, behavioral, or medical conditions:

Sacraments your child has received:*

BaptismFirst ReconciliationFirst Communion

Student Name #3*

First NameLast Name

Grade they're entering in September 2024 (K-5 only)*

Student Date of Birth*

ex: 01/01/10

List any learning, behavioral, or medical conditions:

Sacraments your child has received:*

BaptismFirst ReconciliationFirst Communion

Student Name #4*

First NameLast Name

Grade they're entering in September 2024 (K-5 only)*

Student Date of Birth*

ex: 01/01/10

List any learning, behavioral, or medical conditions:

Sacraments your child has received:*

BaptismFirst ReconciliationFirst Communion

How would you like to pay?*

By CardBy Check

Payment by Card

Religious Education Registration: 1 Student

$70.00

Religious Education Registration: 2 Students

$135.00

Religious Education Registration: 3 or more Students

$185.00

Total

$0.00

Payment Methods

Credit Card

Apple Pay

We've received your Religious Education registration form. For any questions, please reach out to religioused@stpiusxloudonville.org

If you chose to pay by check, please make all checks payable to St. Pius X Church Religious Education

Registration Fee:

1 Student: $70

2 Students: $135

3+ Students: $185