Course Registration Form

St. Mary Roman Catholic Church 2023 -2024 Registration Form

Please complete the form below and submit.
Religious Education Fees 2023-2024

Please make check payable to St Mary Catholic Church as per your registration total. Please make "Religious Education Fee" note in the MEMO portion of your check. Mail to St. Mary Catholic Church 210 W Main St. Manchester, MI 48158

Religious Education - 1st through 7th Grades (One Child)....$100.00

Catechesis of the Good Shepherd: (One Child)..................... $100.00

Two or More Children Registered in RE and/or CGS...............$150.00

8th Grade Confirmation Preparation......................................$150.00

1st Communion Preparation Fee Per Child (2nd Grade).........$50.00

Children of staff members and catechists please waive registration fees. If financial assistance is requested please contact Lori Feiler at stmarymanchester.dre@gmail.com
Total Number of Children Registered*
Total Number of Children Registered per Family
TOTAL Registration Fee *
Enter TOTAL REGISTRATION Amount. Please mail check to office.
Family Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mother/Guardian Full Name*
First and Last Name
Mother's Maiden Name
Full Maiden Name for Sacramental Record
Mother/Guardian Mobile Number*
Format: (000) 000-0000.
Mother/Guardian Email Address*
example@example.com
Father/Guardian Full Name*
First and Last Name
Father/Guardian Mobile Number*
Format: (000) 000-0000.
Father/Guardian Email Address*
example@example.com
Emergency Contact Name and Relationship*
Name/Relationship
Emergency Mobile Number*
Format: (000) 000-0000.
Family Insurance Provider/Health Plan*
Name/Group Number
First Student Name*

First NameMiddle NameLast Name
Religious Education/CGS Sessions 2023-24*
Choose One Session Per Child
Sacraments Completed*
List Completed Sacraments
Sacraments Completed*
Parish Name and Approximate Date Completed
Student Medical Information*
Please include any Medical Information (medications, allergic reactions, physical, emotional/pshcyological limitations)
Second Student Name

First NameMiddle NameLast Name
Religious Education Class 2023-24
Sacraments Completed
List Completed Sacraments
Sacraments Completed
Parish Name and Approimate Date Completed
Student Medical Information
Please include any Medical Information (medications, allergic reactions, physical, emotional/pshcyological limitations)
Third Student Name

First NameMiddle NameLast Name
Religious Education Class 2023-24
Sacraments Completed
List Completed Sacraments
Sacraments Completed
Parish Name and Approximate Date Completed
Student Medical Information
Please include any Medical Information (medications, allergic reactions, physical, emotional/pshcyological limitations)
Photography/Internet Parent Permission

I grant permission for my child(ren) to be photographed and or/video recorded during authorized St. Mary Religious Ed/CGS and parish activities . If at any time my child(ren) decline, this will be honored. I also grant permission for my child(ren)'s photos and name(s) to be published on the St Mary's webpage, parish bulletins, displays and newsletters. Furthermore I understand that St Mary Parish are unable to prevent unauthorized copying, altering and republishing. I hereby grant St. Mary Parish a waiver from all liability in such unathorized activity.
- I indicate this by signing the signature box below.
I DO NOT grant permission for photos to be taken of my child(ren) and my child(ren) will be asked to separate from the group during photography or video.
- I indicate this by NOT SIGNING the signature box below.
Photo Release Signature

Powered by Jotform SignClear
Should be Empty:

St. Mary Roman Catholic Church 2023 -2024 Registration Form