PSR Family Registration

PSR Family Registration

Welcome to the St. Michael's Parish School of Religion (PSR) Family Registration Form for 2025-2026. Please see emailed information for required forms that will need brought to the first class.
Person's Name Filling Out Registration
Home Parish
Parent/Guardian Filling Out Form

This parent/guardian will automatically be put into our text and email system. All following parent/guardians have the option to be in our text system, but are not required. This will also be the first parent/guardian we contact with questions or in an emergency.
Guardian Title

Other
First Name
Last Name
Cell Phone
Back-up Phone Number
Email Address
example@example.com
Home Address (Please include City)
Religious Affiliation*

Other
Parent/Guardian #2

This adult is also considered an emergency contact.
Guardian #2 Title

Other
First Name
Last Name
Would you like this adult to be updated and informed through our text and email system?
Phone Number
Back-up Phone Number
Email Address
example@example.com
Home Address (If different from Parent/Guardian #1)
Religious Affiliation

Other
Adult #3 (Optional)

This adult is also considered an emergency contact.
Guardian/Support Title

Other
First Name
Last Name
Would you like this adult to be updated and informed through our text and email system?
Phone Number
Back-up Phone Number
Email Address
Student #1 (Oldest student attending PSR)
Student 1- First Name
Student 1- Last Name
Nickname
Student 1- Mainly Resides with

Other
Date of Birth (Month/day/year)
Grade
If in High School, what is their cell phone number?
If in High School, what is their email address?
example@example.com
Does this child have any allergies or medical conditions requiring special care?
How will this child get home from PSR?
If being picked up (or riding with someone else), who is taking this child home?
Phone number of pick-up person if not listed in the contact section of this form.
Do you have another child to register?
Student #2 (Second Oldest)
Student 2- First Name
Student 2- Last Name
Nickname
Student 2- Mainly Resides with

Other
Date of Birth
Grade
If in High School, what is their cell phone number?
If in High School, what is their email address?
example@example.com
Does this child have any allergies or medical conditions requiring special care?
How will this child get home from PSR?
If being picked up (or riding with someone else), who is taking this child home?
Phone number of pick-up person if not listed in the contact section of this form.
Do you have another child to register?
Student #3
Student 3- First Name
Student 3- Last Name
Nickname
Student 3- Mainly Resides with

Other
Date of Birth
Grade
If in High School, what is their cell phone number?
If in High School, what is their email address?
example@example.com
Does this child have any allergies or medical conditions requiring special care?
How will this child get home from PSR?
If being picked up (or riding with someone else), who is taking this child home?
Phone number of pick-up person if not listed in the contact section of this form.
Do you have another child to register?
Student #4
Student 4- First Name
Student 4- Last Name
Nickname
Student 4- Mainly Resides with

Other
Date of Birth
Grade
If in High School, what is their cell phone number?
If in High School, what is their email address?
example@example.com
Does this child have any allergies or medical conditions requiring special care?
How will this child get home from PSR?
If being picked up (or riding with someone else), who is taking this child home?
Phone number of pick-up person if not listed in the contact section of this form.
Media Authorization
I hereby authorize St. Michael Catholic Church, Girard, KS, the Catholic Diocese of Wichita, and its agents to utilize photographic and/or video images of me or my child(ren). In giving my consent, I hereby indemnify and hold harmless St. Michael Church, Girard, St. Joseph's Church, Arma, the Catholic Diocese of Wichita and its agents from any and all responsibility or liability. I understand that I will receive no compensation should any photograph and/or video of me or my child(ren) be used.
Fee Information

St. Michael's PSR program charges a small fee to help cover costs incurred throughout the year. However, no family will be turned away because they cannot pay.
Money can be brought on the first day of class by parent or student. Make checks payable to St. Michaels, or if sending cash, please make sure it is clearly labeled with your family name.
Should be Empty:

PSR Family Registration

Parent/Guardian Filling Out Form

Parent/Guardian #2

Adult #3 (Optional)

Student #1 (Oldest student attending PSR)

Student #2 (Second Oldest)

Student #3

Student #4

Media Authorization

Fee Information