• St Hilary's Parish Religious Education Program Registration Form

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  • Family/Guardianship Information

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  • Name of person/relationship legally responsible for Religious Education if not a Parent or Legal Guardian

    *Parent/guardian must provide a signed, dated letter of permission to Noreen Forkin (sthilaryprep@gmail.com), which is to be kept on file and updated annually.

  • First Child Details

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  • Medical/Learning Questions for First Child

  • * IDEA: As defined by Individuals with Disability Education Act (IDEA), the term "child with 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. 

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

  • Second Child Details

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  • Medical/Learning for Second Child

  • * IDEA: As defined by Infividuals with Disability Education Act (IDEA), the term "child with 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, antoher health impairment, a specific learning disability, deaf-blindness, or multiple disabilities, and who, by reason thereof, needs special education and related services. 

    ** ImmunizationL Even if your child is exempt from immunizations, he/she may be excluded from school during an outbreak of the vaccine preventable disease.

  • Third Child Details

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  • Medical/Learning Questions for Third Child

  • * IDEA: As defined by Infividuals with Disability Education Act (IDEA), the term "child with 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, antoher health impairment, a specific learning disability, deaf-blindness, or multiple disabilities, and who, by reason thereof, needs special education and related services. 

    ** ImmunizationL Even if your child is exempt from immunizations, he/she may be excluded from school during an outbreak of the vaccine preventable disease.

  • Fourth Child Details

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  • Medical/Learning Questions for Fourth Child

  • * IDEA: As defined by Infividuals with Disability Education Act (IDEA), the term "child with 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, antoher health impairment, a specific learning disability, deaf-blindness, or multiple disabilities, and who, by reason thereof, needs special education and related services. 

    ** ImmunizationL Even if your child is exempt from immunizations, he/she may be excluded from school during an outbreak of the vaccine preventable disease.

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