St. John the Baptist Religious Education Registration Form

St. John the Baptist Religious Education Registration Form

2024-2025
Welcome to registration for the 2024-2025 Religious Education school year!

Religious Education classes, including First Communion and Confirmation preparation, will be held Sundays from 9:00 a.m. - 12:00 p.m. and include 11 a.m. Mass. Parents are invited to attend Mass with their child each week. Families that already have a tradition of attending a different weekend Mass are encouraged to continue and may pick up their child by 10:50 a.m. or after 11 a.m. Mass.

We strongly encourage the use of online registration. If you have no alternative, please contact the Religious Education Office at 815-498-2010.

If you have any questions while registering, contact the Religious Education office at (815) 498-2010 or lisashort@stjbsom.org.

We look forward to you joining us in 2024-2025!
Family Information
Please pick one:*

I am a new family to Religious Education.I am a returning family from 2023-2024.I am a returning family but did not participate in 2023-2024.
Family Last Name*
Street Address (including city and zip code)*
Mailing Address (if different from Street Address)
Home Phone Number (landline, if applicable)
Father/Guardian Name

First NameLast Name
Father/Guardian Cell Phone

Area CodePhone Number
Father/Guardian Email
example@example.com
Mother/Guardian Name

First NameLast Name
Mother/Guardian Cell Phone
Mother/Guardian Email
example@example.com
Mother Guardian Maiden Name
Children Live With*

Both ParentsFatherMotherGuardian/RelativeSplit Time between Parents
If children live with a guardian/relative, please select relationship to child.

GrandparentsAunt/UncleFosterOther
Student Information
Number of Children Enrolling in Religious Education*
If you are enrolling more than 5 students, please complete this form for the first five children and contact the Religious Education Office at 815-498-2010 to register additional students.
Student 1
Child's Name

First NameLast Name
Nickname
Gender
Date of Birth

MonthDayYear
Date
Grade in 2024-2025
Name of School
Medical Problems, Allergies, or Learning Disabilities
Student 2
Name

First NameLast Name
Nickname
Gender
Date of Birth

MonthDayYear
Date
Grade in 2024-2025
Name of School
Medical Problems, Allergies, or Learning Disabilities
Student 3
Name

First NameLast Name
Nickname
Gender
Date of Birth

MonthDayYear
Date
Grade in 2024-2025
Name of School
Medical Problems, Allergies, or Learning Disabilities
Student 4
Name

First NameLast Name
Nickname
Gender
Date of Birth

MonthDayYear
Date
Grade in 2024-2025
Name of School
Medical Problems, Allergies, or Learning Disabilities
Student 5
Name

First NameLast Name
Nickname
Gender
Date of Birth

MonthDayYear
Date
Grade in 2024-2025
Name of School
Medical Problems, Allergies, or Learning Disabilities
Emergency Contact
Please provide an emergency contact OTHER THAN PARENT/GUARDIAN. In the event of an emergency, the parent/guardian will be contacted first. If the parent/guardian cannot be reached, then the emergency contact will be called.
Alternate Emergency Contact Name (not parent/guardian)*
Relationship*
Phone Number*
Please enter a valid phone number.
Communication Preferences
The Religious Education Office uses Flocknote to communicate information such as updates, schedule changes, important events and cancellations. At least one parent/guardian must receive these communications for emergency purposes. Parents who want their Confirmation students to receive updates and reminders directly should choose "other" and provide the student's information.
Person(s) to Receive Flocknotes*
Number of "Other" People to Receive Flocknotes. Provide contact info below.
Name of Person 1

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Name of Person 2

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Name of Person 3

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Tuition and Payment
Tuition for the 2024-2025:

1 student = $90

2 students = $150

3 students = $200

4 or more students = $250

Payment is due September 15, 2024. Families who are are unable to pay all or part of their fees or would like to setup a payment plan may contact Judy Kreczmer at 815-353-6562 or Fr. Naill at 815-498-2010 to discuss other possible arrangements.
Payment Method*

Credit/Debit - To pay by credit or debit, please visit https://www.givecentral.org/location/439/event/26448 (Link will be provided again on the confirmation screen after form submission.)Check/Cash - Payment can be dropped off at the Parish Office, dropped in the collection basket during Mass or mailed to St. John the Baptist Catholic Church, Attn: Religious Education, P.O. Box 276, Somonauk, IL 60552
Permissions and Conditions
I am the parent or legal guardian of the child(ren) indicated above.*

YesNo
First-Aid/Emergency Treatment: I authorize St. John the Baptist employees and volunteers to administer first-aid to my child if deemed necessary and appropriate to preserve the life, limb or well-being of my child. I authorize the Parish to contact and engage medical personnel and arrange for emergency treatment of my child, including transportation for medical, dental, surgical or hospital care or diagnosis, and I consent to that treatment for my child. I agree that I am financially responsible for such medical treatment.*

YesNo
Media Release: I grant the Parish and/or the Diocese of Rockford permission to use my my child’s image and likeness in any photograph, video, television broadcast, internet site, audio-recording, and in any and all of its publications, including website entries (collectively “promotional materials”).*

YesNo
If we publish in The Observer/El Observador Diocesan newspaper, I grant permission for my child(ren)'s name to be published.*

YesNo
Name of Person Completing Form*
Email of Person Completing Form*
example@example.com
Date*

MonthDayYear
Date
Signature*

Clear
Should be Empty:

St. John the Baptist Religious Education Registration Form

Family Information

Student Information

Student 1

Student 2

Student 3

Student 4

Student 5

Emergency Contact

Communication Preferences

Tuition and Payment

Permissions and Conditions