2023-24 SM & SOZ Religious Education Program New Family Registration Grades 1-11

2023 - 2024 SM & SOZ Religious Education Program New Family Registration Grades 1-11(DOES NOT INCLUDE SACRAMENTAL REGISTRATION)

If your child will be receiving a sacrament this year, please fill out the additional 2023-2024 Sacramental Registration Form.
Date

MonthDayYear
Date
Parish Member:
If nonmember, please list which parish you belong to:
Child(ren) reside(s) with:
Father
Name

First NameMiddle NameLast Name
Religion:
Marital Status
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone:
Cell Phone:
Work Phone:
Email
example@example.com
Mother
Name

First NameMiddle NameLast Name
Religion:
Marital Status
Address if different from Father

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone:
Cell Phone:
Work Phone:
Email
example@example.com
Guardian(s)
Name

First NameMiddle NameLast Name
Religion:
Marital Status
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone:
Cell Phone:
Work Phone:
Email
example@example.com
Name

First NameMiddle NameLast Name
Religion:
Marital Status
Address, if different from above

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone:
Cell Phone:
Work Phone:
Email
example@example.com
Preferred Contact Method:

For Communication: Announcements and Newsletters
Preferred Contact Method:
Child(ren) Registering

If you are registering more than 5 children, please email DRE. Please enter each child's information below.
Child

First NameMiddle NameLast NameGrade Entering
Gender
Birthdate

MonthDayYear
Date
Additional information: Allergies, Special Needs, Accommodations

Sacramental Information

Rows	Yes	No
Baptized
First Reconcilliation
First Communion
Confirmation

A copy of the baptismal certificate for each child registering is required of all new students.
Please upload your child's baptismal certificate(s) here:

Browse Files

Cancelof
Child

First NameMiddle NameLast NameGrade Entering
Gender
Birthdate

MonthDayYear
Date
Additional information: Allergies, Special Needs, Accommodations

Sacramental Information

Rows	Yes	No
Baptized
First Reconcilliation
First Communion
Confirmation

Please upload your child's baptismal certificate(s) here:

Browse Files

Cancelof
Child

First NameMiddle NameLast NameGrade Entering
Gender
Birthdate

MonthDayYear
Date
Additional information: Allergies, Special Needs, Accommodations

Sacramental Information

Rows	Yes	No
Baptized
First Reconcilliation
First Communion
Confirmation

Please upload your child's baptismal certificate(s) here:

Browse Files

Cancelof
Child

First NameMiddle NameLast NameGrade Entering
Gender
Birthdate

MonthDayYear
Date
Additional information: Allergies, Special Needs, Accommodations

Sacramental Information

Rows	Yes	No
Baptized
First Reconcilliation
First Communion
Confirmation

A copy of the baptismal certificate for each child registering is required of all new students.
Please upload your child's baptismal certificate(s) here:

Browse Files

Cancelof
Child

First NameMiddle NameLast NameGrade Entering
Gender
Birthdate

MonthDayYear
Date
Additional information: Allergies, Special Needs, Accommodations

Sacramental Information

Rows	Yes	No
Baptized
First Reconcilliation
First Communion
Confirmation

A copy of the baptismal certificate for each child registering is required of all new students.
Please upload your child's baptismal certificate(s) here:

Browse Files

Cancelof

WHAT ARE THE TUITION FEES?

Registration Fees are as follows:

Number of Children	St. Mary & Sons of Zebedee Parish Members	Non-parish Member
1	$65.00	$130.00
2	$115.00	$230.00
3+	$155.00	$310.00

*Tuition does not include retreat fees or sacramental fees and is nonrefundable.

HOW DO I PAY MY TUITION FEES?

Payment should be sent upon completion of this form.

Completed forms/payment DUE August 1st, 2023

Memo line of check: REL ED FEES

Mail payment to: St. Mary Parish, Attn: DRE 699 Milwaukee St., Lomira, WI 53048

Drop payment in collection in a plain (noncontribution) envelope: Attn: Lesa Staehler, DRE

Drop envelope with a payment in the SM Parish Office Mail Slot: Attn: Please give to Lesa Staehler, DRE
Volunteer Discount: Anyone who volunteers as a Catechist, Aide, or Hall Monitor will receive a discount on religious education fees of One Free Tuition of an Immediate Family Member enrolled in grades 1-10. This does not include Sacramental Fees.
If Yes, Safe Environment Training:
If Yes, Select Volunteer Role
If yes, please include name and best time to contact:
Required Forms

Please complete and electronically sign and date the following forms below.
I give my consent for the following Child(ren)/Youth Communication Methods (check off all that apply) (This mainly applies to middle and high school youth as some prefer to be texted or emailed information regarding class or for them to correspond about missing work, etc. Social Media Platforms would only be used in the event that we are not allowed to meet in-person per an Archdiocese order)
SIGNATURE OF PARENT/ LEGAL GUARDIAN:
Archdiocese of Milwaukee Release of Information

I consent that any still or electronic image and/or audio recording, in which I or my child may appear, maybe used by St. Mary and Sons of Zebedee Religious Education/Family Faith Program. I understand that these materials are being used for promotion St.Mary and Sons of Zebedee Parishes. The images and/or recordings may be used to support recruitment, fundraising, evangelization and other communication efforts. I release the staff and volunteers and I understand and agree that the use of my picture is not an invasion of privacy. Neither I, nor anyone claiming to be speaking on my behalf, will later object to the use of this/these photographs by the parish.
Signature of parent or legal guardian
Safeguarding God’s Children / Family
Signature of parent or legal guardian
Additional Child & Youth optional parish activities offered by the Faith Formation Ministry
Signature of parent or legal guardian
Family email and phone permission to share
Signature of parent or legal guardian
All Required Forms signed on this date:

MonthDayYear
Date
Emergency Contact Information
In the event of a last minute cancellation or medical emergency, please list two phone numbers to contact you (parents):
Name to contact in the event of an emergency

First NameLast Name
Name to contact in the event of an emergency

First NameLast Name
Phone Number

Area CodePhone Number
Phone Number

Area CodePhone Number
Other Emergency Contacts (not parents - please list at least one)
Name

First NameLast Name
Name

First NameLast Name
Phone Number

Area CodePhone Number
Phone Number

Area CodePhone Number
Relationship to the Parent
Relationship to the Parent
(OPTIONAL) My child(ren) may be released to the following people (non guardian or parent) at class dismissal:
Name

First NameLast Name
Name

First NameLast Name
Name

First NameLast Name
Name

First NameLast Name
Emergency Medical Treatment
Signature of parent or legal guardian
Signed on this date:

MonthDayYear
Date
Should be Empty:

2023 - 2024 SM & SOZ Religious Education Program New Family Registration Grades 1-11(DOES NOT INCLUDE SACRAMENTAL REGISTRATION)

Father

Mother

Guardian(s)

Preferred Contact Method:

Child(ren) Registering

Required Forms

Emergency Contact Information